COMPARISON OF STREPTOKINASE AND UROKINASE IN LOCAL THROMBOLYSIS OF PERIPHERAL ARTERIAL OCCLUSIONS FOR LOWER-LIMB SALVAGE

PURPOSE: To compare the efficacy and safety of streptokinase (SK) and urokinase (UK) in the treatment of local thrombolysis. PATIENTS AND ME THODS: Over a 24-month period, 40 patients with 45 lower limb arterial occlusions of less than 45 days duration underwent intraarterial fibr inolysis. Twenty occlusions were treated with recombinant UK and tissu e culture-derived UK, and 25 occlusions were treated with SK. The stud y was retrospective, but the two groups were very homogeneous in terms of vascular surgical history, medical risk factors, and occlusion cha racteristics. RESULTS: Complete lysis (95% or more) was achieved in 84 % of SK infusions and 89% of UK infusions. Endoluminal and surgical in terventions as well as clinical outcomes of SK and UK treatment were c omparable. However, infusion time was significantly longer for SK trea tment: 28.5 hours versus 19.1 hours for UK treatment (P = .035). Compl ication 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 statisticall y significant (7.7 days for SK vs 8.7 days for UK). CONCLUSION: At the concentrations and doses used, the efficacy and safety of SK and UK w ere comparable, despite longer SK infusion time.