THROMBOLYTIC THERAPY OF DEEP-VEIN THROMBO SIS IN THE LOWER-LIMBS

Intravenous heparin is still the basic treatment of deep vein thrombos is in the lower limbs. However, its weak action on the blood clot and its poor efficiency in the prevention of functional sequelae have resu lted in its replacement by thrombolytic agents. Streptokinase produces a more than 50 percent lysis of the thrombus 4 times more flequently than heparin, but the result depends on the degree of venous occlusion and on the site and duration of the thrombosis. The risk of pulmonary embolism does not seem to be increased, but haemorrhagic accidents ar e 3 times more frequent than with heparin. The long-term benefit on fu nctional venous sequelae is questionable, the best results being obtai ned by an early treatment with complete recanalization of the vein and absence of recurrence. The value of thrombolytic agents in the treatm ent of deep vein thrombosis has therefore not been demonstrated, but t hey can reasonably be prescribed to young patients with recent proxima l and non occlusive phlebitis.