Catheter-directed low dose streptokinase infusion: a preliminary experience.

Fifty-six patients with acute or chronic arterial or venous thromboembolic occlusions received treatment with low dose (5,000 U per hour) streptokinase via an indwelling intravascular catheter. Successful clot lysis was achieved in 13 of 14 (92%) postprocedural occlusions that were less than one week in age, in 8 of 11 (73%) atherosclerotic occlusions that were less than six weeks in age, in 2 of 3 (67%) emboli from cardiac thrombi, and in all of the pulmonary emboli and superior vena cava occlusions. In the chronic occlusions, successful thrombus lysis occurred less frequently (8 of 21, 38%). Although the initial objective of fibrinolytic therapy is clot lysis, the long term clinical success depends on the diagnosis and treatment of the underlying cause of the thromboembolism.