Radiology, Vol 161, 597-599, Copyright © 1986 by Radiological Society of North America
Intraarterial fibrinolysis: in vitro and prospective clinical evaluation of three thrombolytic agents
E Pilger, J Lammer, H Bertuch and H Steiner
In order to investigate and compare the fibrinolytic activity of
streptokinase, streptokinase-Glutamine-plasminogen, and urokinase for
intraarterial fibrinolysis, as in vitro test and a prospective trial were
performed. For the in vitro demonstration of lytic activity, fibrin plates
with plasminogen and fibrin plates without plasminogen were incubated with
streptokinase; with streptokinase-plasminogen in molar proportions of 1:1,
1:2, and 2:1, and with urokinase. In order to examine the in vivo activity
of the different lytic solutions, 98 patients suffering from peripheral
arterial occlusions were divided into three homogeneous groups for
treatment with streptokinase, streptokinase-plasminogen, and urokinase.
Although urokinase was superior to streptokinase on the fibrin plate with
plasminogen, no difference was demonstrated in vivo between the two lytic
agents. Streptokinase-plasminogen in a molar proportion of 1:2 showed
significantly higher fibrinolytic activity than any other solution.
Therefore, the fibrinolytic agent of choice for intrathrombotic injections
seems to be a 1:2 solution of streptokinase with plasminogen or with the
lytic enzyme plasmin itself.
