Comparison of streptokinase and urokinase in local thrombolysis of peripheral arterial occlusions for lower limb salvage.
OBJECTIVE
To compare the efficacy and safety of streptokinase (SK) and urokinase (UK) in the treatment of local thrombolysis.


METHODS
Over a 24-month period, 40 patients with 45 lower limb arterial occlusions of less than 45 days duration underwent intraarterial fibrinolysis. Twenty occlusions were treated with recombinant UK and tissue culture-derived UK, and 25 occlusions were treated with SK. The study was retrospective, but the two groups were very homogeneous in terms of vascular surgical history, medical risk factors, and occlusion characteristics.


RESULTS
Complete lysis (95% or more) was achieved in 84% of SK infusions and 89% of UK infusions. Endoluminal and surgical interventions as well as clinical outcomes of SK and UK treatment were comparable. However, infusion time was significantly longer for SK treatment: 28.5 hours versus 19.1 hours for UK treatment (P = .035). Complication rates were not statistically significantly different. Average length of stay in the intensive care unit was identical (2.2 days) for both groups, and the difference in hospital stay was not statistically significant (7.7 days for SK vs 8.7 days for UK).


CONCLUSIONS
At the concentrations and doses used, the efficacy and safety of SK and UK were comparable, despite longer SK infusion time.
Dubé
M
M
Department of Radiology, Hôtel-Dieu de Montréal Hospital, Quebec, Canada.
Soulez
G
G
Thérasse
E
E
Cartier
P
P
Blair
J F
JF
Roy
P
P
Robillard
P
P
Bruneau
L
L
Van Nguyen
P
P
Cusson
J R
JR
D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D003422:Critical Care; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007866:Leg / Q000098:blood supply*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D013300:Streptokinase / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D013300:Streptokinase; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator