FIBRINOLYTIC THERAPY OF THROMBOPHLEBITIS. TWENTY-FIVE CASES STUDIED WITH SERIAL VENOGRAMS.

Twenty-five patients with deep thrombophlebitis, whose symptoms were of less than five days' duration, had serial venograms made before and after combined streptokinase-plasmin-anticoagulant therapy. Of 20 patients presenting with evidence of inflammation, 18 were asymptomatic within five days. Evidence provided by venograms suggests that thrombolysis of varying degree occurred in eight of 23 patients with comparable pre-treatment and post-treatment venograms. In only two patients was flow restored through a major venous channel. Thus, in most cases, no evidence was adduced that the administration of Thrombolysin(R) (derived from the euglobulin fraction of human plasma, activated with streptokinase and containing both preformed plasmin and plasminogen activator activity) added significantly to heparin therapy. With the dosage schedule of streptokinase-plasmin and anticoagulants employed, pulmonary embolism occurred in two cases and hemorrhagic phenomena in three patients, exclusive of oozing from the sites of injection. Side effects were minimal. Although thrombolysis did not occur in most cases studied, there is currently no adequate way to predict success or failure in the individual patient. One may hope for better results when the optimal choice of thrombolytic agent, dosage schedule, method of administration and anticoagulant programs are established.