Streptokinase in iliofemoral venous thrombosis

Mavor, G. E.; Bennett, Bruce; Galloway, J. M. D.; Karmody, Allastair M.

doi:10.1002/bjs.1800560804

Cited by 40 publications

(16 citation statements)

References 14 publications

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“…To test the accuracy of the fibrinogen time-concentration slope displayed in figure 1, which was constructed from multiple random fibrinogen levels of various numbers per patient, a second time-concentration slope was calculated from a subset of 15 patients in whom at least four serial levels had been measured after the infusion of streptokinase at intervals of no less than 4 and usually 6 hr ( figure 3). The nearly identical slope b of 4.9 mg/dl/hr attests to the validity of figure 1.…”

Section: Resultsmentioning

confidence: 99%

Hemorrhage and the products of fibrinogen digestion after intracoronary administration of streptokinase.

Timmis¹,

Gangadharan²,

Ramos³

et al. 1984

Circulation

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Hemorrhage was prospectively identified in 26 of 116 consecutive patients (23%) who were receiving intracoronary streptokinase for occlusive coronary thrombi producing infarction. Bleeding was not influenced by the dose of streptokinase or the method of cardiac catheterization. Before treatment, prothrombin time and partial thromboplastin time were normal in both bleeders and nonbleeders. Fibrinogen levels measured by bioassay after streptokinase (mean + SEM) were 62 29 mg/dl in patients with major bleeding, 1 11 ±+ 26 mg/dl in patients with minor bleeding, and 109 + 13 mg/dl in nonbleeders (p -NS). The regression slope b calculated from poststreptokinase fibrinogen time-concentration data in 71 patients was 4.7 mg/dl/hr. However, mean fibrinogen concentrations calculated at sequential 5 hr intervals revealed no net regeneration for the first 20 hr after thrombolysis. The apparent fibrinogen regeneration rate was less than normal (31 mg/kg/day) for more than 10 hr but subsequently increased to 94 10 mg/kg/day by the second day. The initial apparent latency of fibrinogen regeneration paralleled the sharp rise in fibrinogen degradation products, which began to decline after 20 hr of treatment but remained elevated well into the second day. Because of their anticoagulant effects, these products may interfere with the fibrinogen assay, causing spuriously low results. Thus, whether the early delay in fibrinogen regeneration is real or simply a reflection of the effects of fibrinogen degradation products on the bioassay, it signals the time for caution in initiating systemic-heparin therapy.

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Section: Resultsmentioning

confidence: 99%

Hemorrhage and the products of fibrinogen digestion after intracoronary administration of streptokinase.

Timmis¹,

Gangadharan²,

Ramos³

et al. 1984

Circulation

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“…Of the two plasminogen activators available for thrombolytic therapy, streptokinase, produced from the 3-haemolytic Streptococcus, has the disadvantage of being both pyrogenic and antigenic, but it is relatively cheap, whereas the alternative human product, urokinase, is neither toxic nor antigenic, but is so costly that its routine use is prohibited. It is also probable that as a thrombolytic agent streptokinase is more effective than urokinase (Mavor et al, 1969c;Mavor et al, 1969d). Reports of streptokinase therapy continue to increase (Kakkar et al, 1969;Browse & James, 1964).…”

Section: Thrombolytic Therapymentioning

confidence: 99%

“…Clinical and experimental experience suggests that streptokinase is best given in high dosage into the region of the thrombus, rather than systemically (Mavor et al, 1969c;Karmody, 1969). Lysis with clearance is readily produced in thrombus completely occluding the iliofemoral segment, even with clot known to be of 30 days' duration (Mavor et al, 1969c).…”

Section: Thrombolytic Therapymentioning

confidence: 99%

“…Lysis with clearance is readily produced in thrombus completely occluding the iliofemoral segment, even with clot known to be of 30 days' duration (Mavor et al, 1969c). Administration of the drug is usually terminated when lysis is complete or well advanced, or in rare instances when no lysis has occurred after normally effective dosage.…”

Section: Thrombolytic Therapymentioning

confidence: 99%

See 1 more Smart Citation

Deep vein thrombosis

Mavor

1971

Postgraduate Medical Journal

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“…5&dquo; Thrombectomy in severe cases has been done since the beginning of the twentieth century,9''° but it was proposed more enthusiastically in the 1960s by several authors.&dquo;,&dquo; This procedure fell into disfavor because, invariably, the thrombosis recurred immediately after the operation and the long-term results were poor. [2][3][4][5][6]14 Most reports in the literature in the 1960s described removal of the thrombus from the vein3,4,7,11-14 but did not focus on why the vein thrombosed in the first place. Since the conditions leading to the thrombosis were not eliminated, the veins usually rethrombosed postoperatively.…”

Section: Introductionmentioning

confidence: 99%