Intra-arterial fibrinolytic therapy. Efficacy of streptokinase vs urokinase.
This study is a retrospective comparison of the results in 25 low-dose, intra-arterial streptokinase and 12 low-dose intra-arterial urokinase infusions for thromboembolic disease. Intra-arterial streptokinase was successful in 50% of infusions and was marked by significant abnormalities in the coagulation criteria. There was a high incidence of major and minor bleeding (48% overall), which could be attributed to systemic effects of the drug. Urokinase was successful in 100% of infusions, and showed no significant effects on systemic coagulation criteria. There were also fewer complications during urokinase infusion. The average pharmacy cost for a course of intra-arterial streptokinase was $165, while urokinase cost $1142. Despite the significant difference in expense, the increased efficacy and safety of urokinase make it the preferred agent for intra-arterial infusion. Theoretical reasons for the increased effectiveness of urokinase are discussed.
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001777:Blood Coagulation / Q000187:drug effects; D002561:Cerebrovascular Disorders / Q000139:chemically induced; D003365:Costs and Cost Analysis; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013300:Streptokinase / Q000008:administration & dosage* / Q000009:adverse effects; D013923:Thromboembolism / Q000139:chemically induced; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects
D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator