Systemic fibrinolytic treatment of chronic arterial occlusion in the elderly

Abstract

Systemic fibrinolytic therapy is effective in dissolving chronic arterial occlusions. In the present study, ultra-high streptokinase short-term lysis was the treatment of choice. It consisted of one to three infusion series of 9 million IU SK over 6 hours each. In about 50% of patients, a subsequent catheter dilation was carried out either for widening residual stenoses or for clearance of vessels still occluded. Patients treated were 176 younger than 65 years and 165 older. Targets of therapy were iliac and femoral occlusions; iliac occlusions were removed more often in older patients and femoral occlusions more often in younger patients. The rate of cerebral bleeding was 1.14% in the younger and 0.606% in the older patient group. No age-related differences existed for streptokinase plasma concentrations and streptokinase half-life. Plasminogen, on the other hand, which fell during streptokinase infusion to below 10% recovered more slowly in the older than in the younger patients.