Fibrinolytic profiles in local low-dose thrombolysis with streptokinase and recombinant tissue plasminogen activator.
Fibrinolytic parameters have been monitored in 44 patients undergoing local low-dose intra-arterial thrombolysis for acute peripheral arterial ischaemia. Streptokinase (Sk), at a dose of 5,000 units/hr with 250 units/hr heparin, was used in 23 patients and recombinant tissue plasminogen activator (r-tPA) at a dose of 0.5 mg/hr was used in 21 patients. Successful lysis was seen in 18 (86%) patients following r-tPA and in 15 (65%) patients following streptokinase. There were 4 minor haematomas in each group usually at the catheter entry site. Both agents produced a systemic effect, which was still seen 12 hours post-infusion. However, that produced by r-tPA was delayed and significantly reduced compared to that produced by Sk. These results confirm the relative fibrin specificity of r-tPA. When used as a continuous low-dose intra-arterial infusion, r-tPA offers a significantly lower, potentially safer, systemic effect than conventional therapy with streptokinase.
Berridge
D C
DC
Department of Vascular Surgery, University Hospital, Nottingham, UK.
Earnshaw
J J
JJ
Westby
J C
JC
Makin
G S
GS
Hopkinson
B R
BR
D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D013300:Streptokinase; D010959:Tissue Plasminogen Activator