Role of Intra-arterial Streptokinase in Treatment of Arterial Thromboembolism

Traitement thrombolytique des artériopathies

“…La majorité des auteurs [5][6][7][8][9] utilise la streptokinase à une dose moyenne de 5000 U/h. L'efficacité thrombo lytique est au moins égale à celle de la voie intraveineuse avec 50-60% de revascularisa tions [6][7][8], Biologiquement, malgré les fai bles doses horaires, une fibrinolyse systémi que est présente dès les premières heures du traitement [6][7][8] et il n'est pas démontré que les accidents généraux soient moindres qu'avec une administration par voie intravei neuse [6][7][8]. De plus, la mise en place d'un cathéter pendant plusieurs heures dans un cul-de-sac artériel se révèle source de compli cations: Eskridge et al [9] relèvent 26% de thromboses sur le cathéter au cours de 57 traitements.…”

Cost-effectiveness of Intra-arterial Thrombolytic Therapy

“…Heparin sodium (500 to 800 U/h) was (7) 9262 ±1659 (4) Failure_7616 ±2239 (6) 7527 ±1417 (6) Complication_6034 ±1247 (6) 9928 ±2234 (6) …”

Thrombolytic Treatment in Obliterative Arterial Disease

“…5], The majority of authors [5][6][7][8][9] use streptokinase at a mean dose of 5,000 U/h. Thrombolytic efficacy is at least equal to that of intravenous administration, with 50-60% revascularization [6][7][8]. From a laboratory standpoint, despite the low hourly doses, sys temic fibrinolysis is present from the first hours of treatment onwards [6][7][8], and there is no evidence that systemic complications are less than with intravenous administration [6][7][8].…”

“…Thrombolytic efficacy is at least equal to that of intravenous administration, with 50-60% revascularization [6][7][8]. From a laboratory standpoint, despite the low hourly doses, sys temic fibrinolysis is present from the first hours of treatment onwards [6][7][8], and there is no evidence that systemic complications are less than with intravenous administration [6][7][8]. Furthermore, insertion of a catheter for several hours into an arterial cul-de-sac has proved to be a source of complications.…”

“…Such complications linked to thrombolysis, and complications due to the catheter, considerably limit the perspectives of thrombolytic treatment for obliterative arterial disease. Currently, indi cations for thrombolysis arc limited to cases of critical ischemia, dating from less than 4 weeks, and unsuitable for surgical treatment [8]. Risks of complications due to the cathe ter are such that the duration of treatment thus must be limited, with preference given to homolateral catheterization rather than contralateral puncture and total avoidance of the axillary route.…”