Recombinant tissue-type plasminogen activator is superior to streptokinase for local intra-arterial thrombolysis.
The results of local intra-arterial thrombolysis in 98 patients treated with streptokinase and 69 patients treated with recombinant tissue plasminogen activator (rtPA) have been compared. The two groups of patients were well matched and their treatment protocols were identical except with regard to the thrombolytic agent used. Strict criteria for defining successful thrombolysis were used. Successful lysis was achieved in 40 of 98 patients (41 per cent) receiving streptokinase and 40 of 69 patients (58 per cent) receiving rtPA (P less than 0.05). The time to lysis was significantly shorter with rtPA, median time 22 h, than with streptokinase, median time 40 h (P less than 0.002). There was no difference in the incidence of haemorrhagic complications. These results suggest that rtPA is superior to streptokinase for local intra-arterial thrombolysis.
Lonsdale
R J
RJ
Department of Vascular Surgery, University Hospital, Nottingham, UK.
Berridge
D C
DC
Earnshaw
J J
JJ
Harrison
J D
JD
Gregson
R H
RH
Wenham
P W
PW
Hopkinson
B R
BR
Makin
G S
GS
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D011994:Recombinant Proteins; D013300:Streptokinase; D010959:Tissue Plasminogen Activator