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March 11, 1974

The Urokinase-Pulmonary Embolism Trial

Author Affiliations

Rush-Presbyterian-St. Luke's Medical Center Chicago

JAMA. 1974;227(10):1121. doi:10.1001/jama.1974.03230230013003

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To the Editor.—  Dr. Richard Sautter accuses my recent editorial of a misinterpretation of the findings of a cooperative trial organized to evaluate the thrombolytic activity of urokinase in pulmonary embolism.The report did yield valuable data, and the immense amount of detailed work is admirable. What the editorial objected to can be summed up under two headings. First, thrombolytic agents such as streptokinase and urokinase have long been known to dissolve fresh clots in the vascular system. Dr. Sautter and his associates have notably contributed to this subject, having shown quite recently that the response of the fibrinolytic system to surgical stress varies from patient to patient, a subject in which my associates and I have been involved for a long time. Obviously, the defensive mechanisms of the body depend on many factors, and defective thrombolysis may well be an important factor in the formation and lysis of thromboemboli