SELECTIVE INFUSION OF STREPTOKINASE FOR ARTERIAL THROMBOSIS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 93  (6) , 828-833
Abstract
Thirteen patients with limb-threatening ischemia caused by acute arterial thrombosis with selective arterial infusion of streptokinase were treated. The indications for thrombolytic therapy included medical contraindication to surgery, surgically inaccessible thrombi, arterial thrombosis following percutaneous transluminal angioplasty and thrombosed distal arterial bypass. Patients were evaluated with arteriography, Doppler segmental arterial pressure studies and coagulation profile. Objective evidence of complete or partial thrombolysis was demonstrated in 11 of the 13 patients (85%). Treatment after thrombolytic therapy included percutaneous transluminal angioplasty in 6 patients and distal bypass in 2 patients. Of 5 patients who had received no additional treatment, 3 required amputation. Overall limb salvage was achieved in 10 of the 13 patients. The most serious complications were puncture site bleeding in 5 patients, acute renal failure in 1 patient and retroperitoneal hemorrhage in another patient. Bleeding was more frequent in patients with decreased serum fibrinogen levels. Although lysis of acute arterial thrombi can be achieved, thrombolytic therapy alone will allow limb salvage in only a few patients. Selective thrombolytic therapy with streptokinase must be used with caution and is associated with serious complications.