Local venous infusion of streptokinase in DVT

Fourteen patients with acute deep vein thrombosis (DVT) of the thigh were treated with different doses of streptokinase (SK) as a local venous infusion. Only the lowest SK-dose given, 4,000 U/h for 72 h, had any effect. Three out of 9 patients on this dose showed significant lysis. However, systemic hemorrhagic side effects occurred in 3 patients, local dermatitis in another 3. The reason for the limited thrombolytic effect and systemic side effects could be that the catheter is not in the immediate vicinity of the thrombus, and that the SK-infusion by-passes the occluded vein segments through collaterals. There is probably no advantage of local venous SK-infusion over systemic SK-therapy in DVT.