FIBRINOLYTIC TREATMENT WITH ULTRA-HIGH STREPTOKINASE INFUSION VIA THEDORSALIS-PEDIS VEIN OFFERS NO ADVANTAGE OVER SYSTEMIC INFUSION VIA THE BRACHIAL VEIN IN PATIENTS WITH DEEP-VEIN THROMBOSIS OF THE LEG

The present study into the fibrinolytic therapy of deep vein thrombosi s (DVT) considers whether streptokinase infusion into the dorsalis ped is vein of the affected leg (ipsipedal infusion) yields higher lysis r ates than systemic infusion via the brachial vein (systemic infusion). Ln both cases the dosage regimen selected was a short-term ultra-high streptokinase (UHSK) infusion of 1.5 million IU SK/hour over a period of 6 hours (total SK dose: 9 million IU). A series of one to three UH SK infusions was given on one to three consecutive days. Forty patient s acre randomised to either systemic (Group S) or ipsipedal (Group IP) treatment. The distribution of important parameters determining a fib rinolytic response (e.g. the age, site and extent of DVT, and number o f UHSK infusion series) was virtually identical in the two treatment g roups. The rates for total and partial thrombolysis in the systemic in fusion group were 50% and 10% respectively compared with 30% and 20% r espectively in the ipsipedal group. The distribution of side-effects n as approximately identical in the two groups. The results show that ip sipedal UHSK lysis via the dorsalis pedis vein confers no advantage ov er systemic infusion via the brachial vein.