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Venous and Arterial Occlusive Disease Treated By Enzymatic Clot Lysis

Venous and Arterial Occlusive Disease Treated By Enzymatic Clot Lysis Abstract Acute and chronic arterial occlusion (35 cases) and venous occlusion (23 cases) were treated by infusions of purified streptokinase. Success was judged by angiography. Twenty-two patients with venous occlusion completed streptokinase therapy. Of ten patients with thrombosis of less than 14 days, lysis occurred in all. After two weeks but less than three weeks, the conditions of five of seven improved. Thrombi older than three weeks responded in two of six cases. Five cases of early thrombosis unresponsive radiologically to heparin sodium responded favorably to streptokinase. Therapy in the 35 patients with arterial occlusion was successful in 16. Patients with a history of sudden onset of pain or claudication responded favorably. Improvement often occurred without angiographic change. Bleeding from puncture wounds was a minor complication. Stroke, coronary occlusion, and concealed bleeding were fatal in three cases. References 1. Tillett WS, Garner RL: Fibrinolytic activity of hemolytic streptococci . J Exp Med 58:485-502, 1933.Crossref 2. Schwick HG, Heimburger N: Biochemie der Fibrinolyse , in Therapeutische und Experimentelle Fibrinolyse . Stuttgart, West Germany, F. K. Schattauer Verlag, 1969. 3. Alkjaersig N, Fletcher AP, Sherry S: The mechanism of clot dissolution by plasmin . J Clin Invest 38:1086-1095, 1959.Crossref 4. Ogstron D, Ogstron CM, Fullerton HW: The plasminogen content of thrombi . Thromb Diath Haemorrh 15:220-230, 1966. 5. Fletcher AP, Alkaersig N, Sherry S: Pathogenesis of the coagulation defect developing during pathological plasma proteolytic (fibrinolytic) states the significance of fibrinogen proteolysis and circulating fibrinogen breakdown products . J Clin Invest 41:896-916, 1962.Crossref 6. McNicol GP, Wilson PA, Douglas AS: The influence of fibrinogen products on the aggregation of platelets , in Therapeutische and Experimentelle Fibrinolyse . Stuttgart, West Germany, F. K. Schattauer Verlag, 1969. 7. Hirsh J, O'Sullivan EF, Martin M: Evaluation of a standard dosage schedule with streptokinase . Blood 35:341-349, 1970. 8. Nilsson IM, Plow B: Fibrinolysis induced by streptokinase in man . Ada Chir Scand 123:247-266, 1962. 9. Safar J, et al: Effect of the streptokinase-induced fibrinolytic state on the healing of sutured arterial wounds in dogs . J Surg Res 9:649-656, 1969.Crossref 10. Haeger K: The treatment of the severe post thrombotic state . Angiology 19:439-449, 1968.Crossref 11. Bauer G: Heparin as therapeutic against thrombosis: Results of one year's treatment at Mariestad Hospital . Acta Chir Scand 86:267-286, 1942. 12. Edwards EA, Edwards JE: Effect of thrombophlebitis on venous valve . Surg Gynecol Obstet 65:310-320, 1937. 13. Donaldson GA, Linton RR, Rodkey GV: A 20 year survey of thromboembolism at the Massachusetts General Hospital, 1939-1959 . N Engl J Med 265:208-214, 1961.Crossref 14. Piccone VA, et al: The late results of caval ligation . Surgery 68:980-998, 1970. 15. Altmeier WA, Hill EO, Fullen WD: Acute and recurrent thromboembolic disease . Ann Surg 170:547-558, 1969.Crossref 16. Robertson BR: On thrombosis, thrombolysis and fibrinolysis . Acta Chir Scand , (suppl 421) , 1971. 17. Kakkar VV, et al: Treatment of deep vein thrombosis with streptokinase . Br J Surg 56:178-183, 1969.Crossref 18. Miller GAH, et al: Comparison of streptokinase and heparin in treatment of isolated, acute massive pulmonary embolism . Br Med J 2:681-687, 1971.Crossref 19. Urokinase pulmonary embolism trial, National Heart and Lung Institute, National Institutes of Health, Phase I Results . JAMA 214:2163-2172, 1970.Crossref 20. Pitney WR, et al: Treatment of experimental venous thrombosis with streptokinase and ancrod (Arvin) . Br J Surg 58:442-447, 1971.Crossref 21. Amery A, et al: Outcome of recent thromboembolic occlusions of limb arteries treated with streptokinase . Br Med J 4:639-644, 1970.Crossref 22. Hume N, et al: Streptokinase for chronic arterial occlusion . Arch Surg 101:653-657, 1970.Crossref 23. Poliwoda H, et al: Treatment of chronic arterial occlusions with streptokinase . N Engl J Med 280:689-692, 1969.Crossref 24. Verstraete M, Vermylen J, Donati MB: The effect of streptokinase infusion on chronic arterial occlusions and stenoses . Ann Intern Med 74:377-382, 1971.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Venous and Arterial Occlusive Disease Treated By Enzymatic Clot Lysis

LeVeen, Harry H.; Diaz, Carlos A.
Archives of Surgery , Volume 105 (6) – Dec 1, 1972
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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1972.04180120102019
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Abstract

Abstract Acute and chronic arterial occlusion (35 cases) and venous occlusion (23 cases) were treated by infusions of purified streptokinase. Success was judged by angiography. Twenty-two patients with venous occlusion completed streptokinase therapy. Of ten patients with thrombosis of less than 14 days, lysis occurred in all. After two weeks but less than three weeks, the conditions of five of seven improved. Thrombi older than three weeks responded in two of six cases. Five cases of early thrombosis unresponsive radiologically to heparin sodium responded favorably to streptokinase. Therapy in the 35 patients with arterial occlusion was successful in 16. Patients with a history of sudden onset of pain or claudication responded favorably. Improvement often occurred without angiographic change. Bleeding from puncture wounds was a minor complication. Stroke, coronary occlusion, and concealed bleeding were fatal in three cases. References 1. Tillett WS, Garner RL: Fibrinolytic activity of hemolytic streptococci . J Exp Med 58:485-502, 1933.Crossref 2. Schwick HG, Heimburger N: Biochemie der Fibrinolyse , in Therapeutische und Experimentelle Fibrinolyse . Stuttgart, West Germany, F. K. Schattauer Verlag, 1969. 3. Alkjaersig N, Fletcher AP, Sherry S: The mechanism of clot dissolution by plasmin . J Clin Invest 38:1086-1095, 1959.Crossref 4. Ogstron D, Ogstron CM, Fullerton HW: The plasminogen content of thrombi . Thromb Diath Haemorrh 15:220-230, 1966. 5. Fletcher AP, Alkaersig N, Sherry S: Pathogenesis of the coagulation defect developing during pathological plasma proteolytic (fibrinolytic) states the significance of fibrinogen proteolysis and circulating fibrinogen breakdown products . J Clin Invest 41:896-916, 1962.Crossref 6. McNicol GP, Wilson PA, Douglas AS: The influence of fibrinogen products on the aggregation of platelets , in Therapeutische and Experimentelle Fibrinolyse . Stuttgart, West Germany, F. K. Schattauer Verlag, 1969. 7. Hirsh J, O'Sullivan EF, Martin M: Evaluation of a standard dosage schedule with streptokinase . Blood 35:341-349, 1970. 8. Nilsson IM, Plow B: Fibrinolysis induced by streptokinase in man . Ada Chir Scand 123:247-266, 1962. 9. Safar J, et al: Effect of the streptokinase-induced fibrinolytic state on the healing of sutured arterial wounds in dogs . J Surg Res 9:649-656, 1969.Crossref 10. Haeger K: The treatment of the severe post thrombotic state . Angiology 19:439-449, 1968.Crossref 11. Bauer G: Heparin as therapeutic against thrombosis: Results of one year's treatment at Mariestad Hospital . Acta Chir Scand 86:267-286, 1942. 12. Edwards EA, Edwards JE: Effect of thrombophlebitis on venous valve . Surg Gynecol Obstet 65:310-320, 1937. 13. Donaldson GA, Linton RR, Rodkey GV: A 20 year survey of thromboembolism at the Massachusetts General Hospital, 1939-1959 . N Engl J Med 265:208-214, 1961.Crossref 14. Piccone VA, et al: The late results of caval ligation . Surgery 68:980-998, 1970. 15. Altmeier WA, Hill EO, Fullen WD: Acute and recurrent thromboembolic disease . Ann Surg 170:547-558, 1969.Crossref 16. Robertson BR: On thrombosis, thrombolysis and fibrinolysis . Acta Chir Scand , (suppl 421) , 1971. 17. Kakkar VV, et al: Treatment of deep vein thrombosis with streptokinase . Br J Surg 56:178-183, 1969.Crossref 18. Miller GAH, et al: Comparison of streptokinase and heparin in treatment of isolated, acute massive pulmonary embolism . Br Med J 2:681-687, 1971.Crossref 19. Urokinase pulmonary embolism trial, National Heart and Lung Institute, National Institutes of Health, Phase I Results . JAMA 214:2163-2172, 1970.Crossref 20. Pitney WR, et al: Treatment of experimental venous thrombosis with streptokinase and ancrod (Arvin) . Br J Surg 58:442-447, 1971.Crossref 21. Amery A, et al: Outcome of recent thromboembolic occlusions of limb arteries treated with streptokinase . Br Med J 4:639-644, 1970.Crossref 22. Hume N, et al: Streptokinase for chronic arterial occlusion . Arch Surg 101:653-657, 1970.Crossref 23. Poliwoda H, et al: Treatment of chronic arterial occlusions with streptokinase . N Engl J Med 280:689-692, 1969.Crossref 24. Verstraete M, Vermylen J, Donati MB: The effect of streptokinase infusion on chronic arterial occlusions and stenoses . Ann Intern Med 74:377-382, 1971.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Dec 1, 1972

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