A Prospective Study of Streptokinase and Heparin in the Treatment of Deep Vein Thrombosis

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Abstract
In a prospective trial, 42 medical patients with a history of deep vein thrombosis of less than 5 days were allocated at random to treatment with streptokinase or heparin. Only patient with extensive thromboses were included. Streptokinase was given in a loading dose of 250,000 IU and a maintenance dose of 100,000 IU/h for 4 days as a mean. Heparin was given in a loading dose of 15,000 IU and a maintenance dose of 20,000-50,000 IU/day. The therapeutic results were evaluated by phlebography. Significant thrombolysis occurred in 71.4% of 21 patients treated with streptokinase and in 23.8% of the 21 heparin-treated patients. Using the .chi.2-test for overall association, this difference was statistically highly significant (P = 0.002). Patients (3) in each treatment group experienced major bleeding, 2 in each group requiring blood transfusions. Minor bleeding and slight rise in temperature were encountered more often in the streptokinase than in the heparin group. Patients with acute deep vein thrombosis with proximal extension of the thrombus beyond the calf veins should be offered a therapeutic trial with streptokinase.