Sequential treatment of deep leg vein thrombosis with porcine plasmin and low dose
streptokinase (10,000-20,000 U/h) produces strong systemic fibrinolysis as demonstrated
by the sustained decrease of euglobulin lysis time, of thromboplastin time values
in percent, fibrinogen and factor V levels. There is a statistically significant negative
correlation between thrombolytic results and euglobulin lysis time. Treatment periods
below 3 days are unlikely to give satisfactory results. Occluded vein segments with
an apparent median age of 4 days including thrombi older than 10 days (20% of cases)
are cleared with an average chance of 50%. Complete dissolution of all thrombi proximal
to the crural veins has been demonstrated in 47/114 = 41.2%, some thrombolytic effect
in 31/114 = 27.2% and treatment failure in 36/114 = 31.6%. The data favour laboratory
monitoring of thrombolytic therapy.
Keywords
Deep vein thrombosis - Streptokinase - Porcine plasmin - Vein segment thrombolysis
score - Treatment duration - Clotting parameters - Euglobulin lysis time
