COMPARATIVE RESULTS OF THROMBOLYSIS TREATMENT WITH RT-PA AND UROKINASE - A PILOT-STUDY

Background: The aim of the following prospective study was to investig ate whether patients benefited from locoregional lysis treatment of re cent deep leg vein thrombosis after 1 year. Patients and methods: The prospective study included 69 patients aged between 22 and 58 years, i n whom recent lower leg vein and popliteal vein thromboses were diagno sed by phlebography. Patients were randomized to one of three treatmen t groups: one group was treated Sor a maximum of 7 days with full hepa rinization and daily dose of 20 mg rt-PA administered locoregionally o ver a period of 4 hours; a second group received 100000 IU/h urokinase locoregionally for a maximum of 7 days, in addition to full hepariniz ation; and in the third group (control group), intravenous heparin inf usions after PTT constituted the only form of treatment. All patients were given phenprocoumon from day 7 and received compression treatment . Before treatment began and before the course of phenprocoumon starte d, phlebography and colour duplex sonography examinations were carried out. After 12 months, follow-up duplex sonography was conducted to ev aluate the reflux times over the popliteal vein and the degree of pate ncy of the deep leg veins. Results: Complete lysis was achieved in 6 o f 22 patients in the recombinant tissue plasminogen activator (rt-PA) group and in II of 22 patients in the urokinase group. At follow-up ex amination after 12 months, there were serious post-thrombotic changes in 14 of 22 patients in the rt-PA group, in 9 of 22 patients in the ur okinase group and in 15 of 22 patients in the group of patients who re ceived no lysis treatment. Conclusion: Patients with recently formed t hromboses in the lower leg and popliteal veins who underwent 7 days of locoregional lysis treatment with urokinase demonstrated significantl y fewer clinical symptoms of post-thrombotic syndrome after 1 year tha n those who received locoregional treatment with rt-PA over a similar period or a control group treated with anticoagulants only.