Efficiency of loco regional rt-PA lysis in acute deep venous thrombosis

39 patients suffering from a thrombosis of the peripheral venous system wer e treated with a loco-regional lysis, using rt-PA. Two cycles of 40 mg rt-P A a day were applicated by means of a special drainage-management, using pe rforans veins. During lytic therapy, 20 000 to 30 000 IE of unfractionized heparin were additionally administered. Laboratory work including aPTT and fibrinogen measurement was performed every 8 hours. Additionally a phlebogr aphy was performed after 24 hours. Patients received an anticoagulative the rapy using sintrom or marcumar the following 3 months. We obtained a succes sful thrombolysis without any major complications in 90 %. Minor complicati ons included 3 peripheral pulmonary embolisms. Duplex sonographic and pleth ysmographic follow up was performed in 25 patients one year after operation . In two patients with ankle edema insufficient valves at the popliteal vei n were found with both diagnostic modalities. 23 patients showed no signs o f insufficient valves neither clinically nor at duplex sonography and pleth ysmography. The locoregional lysis appears to be an effective method for th e treatment of acute peripheral vein thrombosis.