THROMBOLYSIS OF DEEP VENOUS THROMBOSIS A FREQUENT INDICATION IN INTERNAL-MEDICINE

Background: For patients with deep vein thrombosis new thrombolytic re gimes are being proposed and demand evaluation in controlled studies. We tested prospectively, how many patients in internal medicine are ca ndidates for thrombolysis. Patients and Methods: All available patient s with the diagnosis of deep vein thrombosis (DVT) in lower extremitie s who were admitted to the service of internal medicine in a medium-si zed hospital during one year were prospectively evaluated for the indi cation of fibrinolysis therapy according to the established criteria. Results: A total of 62 patients were enrolled. Fibrinolysis was not pr oposed in 25 patients aged over 70 years nor in another 9 patients in whom the thrombosis was restricted to calf veins. Nine additional case s had a recurrence of DVT (n = 4) or a history of more than 14 days. A mong the remaining 19 patients, fibrinolysis was not performed in 11 b ecause of advanced malignomas (n = 4) or other diseases (n = 3) with l imited life expectance, enhanced probability of haemorrhage (n = 3) an d obvious non-compliance (n = 1). Eight patients were offered thrombol ytic therapy, but 5 of them denied consent after having been comprehen sively informed. Conclusion: Obviously by far most of patients admitte d to internal medicine for DVT are candidates for standard heparin the rapy only.