Localized intraarterial streptokinase therapy

In a retrospective study, 26 patients underwent 34 episodes of selective intraarterial streptokinase infusion for peripheral arterial thromboembolic occlusive disease. Thrombolytic therapy was beneficial in 23 instances (67 percent), caused no change in 7 instances, and caused deterioration in 4 instances. Nine patients (26 percent) had a major complication and 15 (44 percent) had a minor complication. Puncture site hematoma, which occurred in 11 cases (32 percent), was the most frequent complication. Local thrombolytic therapy is an effective primary or adjuvant method of treatment for thromboembolic occlusive disease in properly selected patients. Protocols for the safe use of streptokinase therapy are necessary. Enthusiasm for thrombolytic therapy must be tempered by the recognition of its potential for serious complications, the requirement for intensive care monitoring, and the availability of dedicated radiologists and vascular surgeons.