Enzymatic Clot Dissolution In Man A New Therapeutic Approach

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Abstract
The fibrinolytic system in man is reviewed and the different components enhancing or inhibiting fibrinolysis (proteolysis) are discussed. The difference between fibrinogenolysis and thrombolysis is stressed and two working hypotheses for the enzymatic treatment of intravascular occlusions are formulated. In the second part of this study, the therapeutic approach inducing increased fibrino(geno)lysis in man is given. The experience with a limited group of patients totalising 26 arterial occlusions is reported. After continuous and prolonged treatment with streptokinase, restoration of arterial flow was obtained in 20 instances (77 %). In all instances the arterial occlusion was demonstrated before treatment with serial arteriograms; control arteriography after treatment was performed in 16 instances. No control series without streptokinase was established to compare the results. With a new administration scheme of streptokinase thrombolysis was obtained in all 16 recent arterial occlusions treated.

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