Is Streptokinase Useful in the Treatment of Deep Vein Thrombosis?

Abstract

Patients with deep vein thrombosis, [15] were studied. Five were treated in the hospital with streptokinase and heparin and 5 only with heparin, 5 were treated at home with only phenprocoumon. All the patients received oral anticoagulant therapy for at least 6 mo. Three to 4 mo. after the acute episode, phlebography and venous pressure measurements were carried out. Streptokinase gave the best results but with more side-effects. In the retrospective study, 51 patients who had had deep vein thrombosis in 1969 were reexamined 31-47 mo. later. More than 50% of the patients with a thrombosis in the femoral and/or iliac vein developed a severe postthrombotic syndrome, in contrast to only 9% of those with a thrombosis in the popliteal vein or lower. On the basis of both the prospective and the retrospective study, patients with a thrombosis in the femoral and/or iliac vein should be treated with either heparin or streptokinase during the early stage. Streptokinase will significantly decrease the frequency and severity of the postthrombotic syndrome in these patients in particular, although this has not yet been proven.