Midwestern Vascular Surgical Society| Volume 93, ISSUE 6, P828-833, June 1983

Selective infusion of streptokinase for arterial thrombosis

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      We have treated 13 patients with limb-threatening ischemia caused by acute arterial thrombosis with selective arterial infusion of streptokinase. 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 six patients and distal bypass in two patients. Of five patients who had received no additional treatment, three required amputation. Overall limb salvage was achieved in 10 of the 13 patients. The most serious complications were puncture site bleeding in five patients, acute renal failure in one 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.
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        • Amery A
        • DeLoof W
        • Vermylen J
        • Verstraete M
        Outcome of recent thromboembolic occlusions of limb arteries treated with streptokinase.
        Br Med J. 1970; 4: 639-644
        • Chaise LS
        • Comerota AJ
        • Soulen RL
        • Rubin RN
        Selective intra-arterial streptokinase therapy in the immediate postoperative period.
        JAMA. 1982; 247: 2397-2400
        • Dotter GT
        • Rosch J
        • Seaman A
        Selective clot lysis with low dose streptokinase.
        Radiology. 1974; 111: 31-37
        • Hume M
        • Gurewich V
        • Thomas DP
        • Dealy Jr, JB
        Streptokinase for chronic arterial occlusive disease.
        Arch Surg. 1970; 101: 653-657
        • Husson JM
        • Fiessinger JN
        • Aiach M
        • Cormier JM
        • Housseth E
        Streptokinase after late failure of reconstructive surgery for peripheral arteriosclerosis.
        J Cardiovasc Surg. 1981; 22: 145-152
        • Katzen BT
        • van Breda A
        Low dose streptokinase in the treatment of arterial occlusion.
        Am J Roentgenol. 1981; 136: 1171-1178
        • Martin M
        Thrombolytic therapy in arterial thromboembolism.
        Prog Cardiovasc Dis. 1979; 21: 351-374
        • Martin M
        • Schoop W
        • Zeitler E
        Streptokinase in chronic arterial occlusive disease.
        JAMA. 1970; 211: 1169-1173
        • Persson AV
        • Thompson JE
        • Patman RD
        Streptokinase as an adjunct to arterial surgery.
        Arch Surg. 1973; 107: 779-784
        • Reichle FA
        • Rao NS
        • Chang KHY
        • Marder V
        • Algazy K
        Thrombolysis of acute and subacute nonembolic arterial thrombosis.
        J Surg Res. 1977; 22: 202-208
        • Sharma GVRK
        • Cella G
        • Parisi AF
        • Sasahara AA
        Thrombolytic therapy.
        N Engl J Med. 1982; 306: 1268-1276
        • Verstraete M
        • Vermylen J
        • Donati MB
        The effect of streptokinase infusion on chronic arterial occlusions and stenoses.
        Ann Intern Med. 1971; 74: 377-382
        • Zarins CK
        • Lu C
        • McDonnell AE
        • Whitehouse Jr, WM
        Limb salvage by percutaneous transluminal recanalization of the occluded superficial femoral artery.
        Surgery. 1980; 87: 701-708