Low-dose streptokinase in the treatment of arterial graft occlusions

During the past 24 months, 19 infrainguinal bypass graft occlusions occurring in 17 patients were treated with local infusions of streptokinase. The treated grafts included three venous femorocrural grafts and four venous and 13 Goretex femoropopliteal grafts. Infusion managed to restore flow completely in 10 grafts. Partial clot lysis occurred in three and no lysis in six grafts. All successful recanalisations occurred within 120 hours of the initiation of thrombolytic therapy. Despite three major complications and the development of two minor haematomas, with an overall success rate of 55% our results support the use of streptokinase in the management of occluded bypass grafts.