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Low-dose streptokinase for selective thrombolysis: systemic effects and complications
Radiology
|July 1, 1984
Summary
Low-dose intravascular streptokinase (SK) causes significant fibrinogen reduction and thrombin time prolongation in all patients. Despite precautions, 10.7% experienced major complications, primarily hemorrhagic, necessitating careful monitoring.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pharmacology
Background:
- Streptokinase (SK) is a thrombolytic agent used to dissolve blood clots.
- Understanding the systemic effects and complications of low-dose intravascular SK is crucial for patient safety.
Purpose of the Study:
- To review the systemic effects and complications of low-dose (5,000 U/hr) intravascular streptokinase in patients.
- To identify correlations between biochemical changes and complication incidence.
Main Methods:
- Retrospective review of 159 patients receiving low-dose intravascular streptokinase.
- Monitoring of plasma fibrinogen levels and thrombin times during treatment.
- Documentation and analysis of systemic effects and complications.
Main Results:
- All patients experienced systemic effects, with 82% showing a 50% decrease in plasma fibrinogen within 4 hours, and 100% by 12 hours.
- Thrombin time prolongation occurred in 42% at 4 hours and 92% at 24 hours.
- No correlation was found between the degree of fibrinogen change/thrombin time prolongation and complication incidence. Seventeen patients (10.7%) had major complications, predominantly hemorrhagic (13/17).
Conclusions:
- Low-dose intravascular streptokinase causes predictable systemic effects, including fibrinogen depletion and prolonged thrombin time.
- Hemorrhagic complications are a significant risk despite precautionary measures.
- Close patient observation and monitoring of plasma fibrinogen levels are essential to minimize complications.