December 1972

Venous and Arterial Occlusive Disease Treated By Enzymatic Clot Lysis

Author Affiliations

Brooklyn, NY
From the Department of Surgery, Brooklyn (NY) Veterans Administration Hospital, and State University of New York, Downstate Medical Center, Brooklyn, NY.

Arch Surg. 1972;105(6):927-936. doi:10.1001/archsurg.1972.04180120102019

Acute and chronic arterial occlusion (35 cases) and venous occlusion (23 cases) were treated by infusions of purified streptokinase. Success was judged by angiography.

Twenty-two patients with venous occlusion completed streptokinase therapy. Of ten patients with thrombosis of less than 14 days, lysis occurred in all. After two weeks but less than three weeks, the conditions of five of seven improved. Thrombi older than three weeks responded in two of six cases. Five cases of early thrombosis unresponsive radiologically to heparin sodium responded favorably to streptokinase.

Therapy in the 35 patients with arterial occlusion was successful in 16. Patients with a history of sudden onset of pain or claudication responded favorably. Improvement often occurred without angiographic change.

Bleeding from puncture wounds was a minor complication. Stroke, coronary occlusion, and concealed bleeding were fatal in three cases.