[Pleural clot ablation and fibrinolytic agents]

Two patients presenting with an important intrapleural clot with cardiorespiratory repercussions were given in situ thrombolytic treatment after drainage with a suction tube had failed. The first patient was treated immediately after thoracophrenolaparotomy for hepatic surgery. Dissolution of the clot was obtained with two local injections of urokinase (450,000 IU). The second patient was treated on the tenth day of a recurring post-traumatic clot, with urokinase (75,000 IU, then 225,000 IU) each day. In addition, this patient received lys-plasminogen locally (15 mukat, then 30 mukat). Dissolution of the clot was complete within five days. Clinical tolerance was excellent and there was no effect on the usual clotting studies. This study confirms previous findings, and underlines the usefulness of this method and its lack of adverse effects, even immediately postoperatively.