Success Rate Of Fibrinolytic Therapy In Fresh And Old Deep Vein Thrombosis
It is still a wide-held belief that fibrinolytic therapy can clear thrombi from deep veins only while they are fresh. We have therefore analysed retrospectively the phlebographic results obtained in 85 patients, all of whom had fibrinolytic therapy for thrombosis of the iliac and/or femoral veins with symptoms present for 1 day to 8 weeks prior to treatment. Streptokinase (n=46), urokinase (n=9), or both drugs successively (n=30) were administered according to our guidelines as recently outlined in detail (Klin. Wschr. 58:521, 1980; Med. Klin. 75:580, 1980) particular emphasis being placed on sufficient duration of thrombolytic therapy with no a priori time limit.Thus, S.C. administration of heparin seems to be as efficient and safe as administration of heparin I.V. in the treatment of patients with acute DVT.The number of cases grouped according to the lenghth of their history and their respective phlebographic outcome as well as the duration of thrombolytic therapy are listed in the table.It can be seen that the success rate was good, when the patient presented with a delay of up to 2 weeks; even during the third or fourth week of the thrombotic episode two thirds of the patients could still be improved. Thereafter the results were uniformly poor.Conclusion: Iliofemoral venous thrombosis can be treated successfully with fibrinolytic drugs for much longer after its onset than is generally accepted.