THROMBOLYTIC THERAPY

An experimental evaluation of the optimal method of use of streptokinase in venous thrombosis

Experiments have been carried out in dogs to determine the optimal method of use of streptokinase in venous thrombosis.

The experiments show that:– High-dose regional infusion is the most efficient system of producing thrombolysis.Occlusive thrombi are readily removed by this system.Low-dose regional infusions and high-dose systemic infusions are much less efficient but, in general, regional delivery is preferable when possible.

As a result of these experimental conclusions a number of patients have been successfully treated with high-dose regional infusions of streptokinase (Mavor, Bennett, Galloway, and Karmody, 1969; Mavor, Galloway, and Karmody, 1970).

The problems of thrombosis in the deep veins of the leg

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Treatment of deep vein thrombosis. A trial of heparin, streptokinase, and arvin

Thirty patients with deep vein thrombosis of the legs of less than four days' duration were allocated at random to treatment with heparin, streptokinase, or Arvin under laboratory control. When the fate of the thrombi was assessed by objective techniques-phlebography and the (125)I-labelled fibrinogen test-the incidence of complete thrombolysis was greatest in the streptokinase group. Complications arose during treatment in each group but were least with Arvin. The natural history of the disease favours clinical but not always anatomical recovery.