Coronary Arterial and Other Intravascular Thromboses Treated with Fibrinolysin

Abstract

This investigation was to determine whether intravascular clots could be lysed by intraarterial or intravenous administration of a fibrinolytic agent. Experimentally, autogenous clots were formed in vitro, and after remaining at room temperature for 3 hours, were inserted into either the coronary or cerebral arteries of mongrel dogs. After arterial occlusion had been demonstrated by arteriography, treatment with the fibrinolytic agent was begun at a dosage of 4,000 m.s.d. units per kg. of body weight. Total lysis of the clots in the coronary arteries was accomplished in 11 of the 21 dogs which survived the procedure, and partial lysis was produced in 9. Clinically, angiography was the most useful of the various procedures employed to obtain objective evidence of response to the fibrinolytic agent. Patients with venous or arterial thromboses were subjected to these measures before and after treatment. Objective evidence of improvement following fibrinolytic therapy was obtained in 8 of the first 27 patients studied and subjective improvement in 17 others.