Thromb Haemost 1983; 50(03): 660-663
DOI: 10.1055/s-0038-1665281
Original Article
Schattauer GmbH Stuttgart

Controlled Multicenter Pilot Study of Urokinase – Heparin and Streptokinase in Deep Vein Thrombosis

J C W van de Loo
1   The Medizinische Universitätsklinik, Münster, FRG
,
A Kriessmann
2   The Medizinische Klinik, Technische Universität Rechts der Isar, München, FRG
,
G Trübestein
3   The Medizinische Universitäts-Poliklinik Bonn, FRG
,
K Knoch
4   The Medizinische Klinik, Städtische Krankenanstalten, Krefeld, FRG
,
C A M de Swart
5   The Kliniek voor Inwendige Geneeskunde, Afdeling Haematologie, Akademisch Ziekenhuis, Utrecht, the Netherlands
,
F Asbeck
6   The Medizinische Universitätsklinik, Abteilung Innere Medizin A, Münster, FRG
,
G A Marbet
7   The Gerinnungslaboratorium, Kantonsspital, Basel, Switzerland
,
H E Schmitt
8   The Universitäts-Institut für Medizinische Radiologie, Kantonsspital, Basel
,
A F Sewell
9   The Abbott Laboratories, North Chicago, III., USA
,
F Duckert
7   The Gerinnungslaboratorium, Kantonsspital, Basel, Switzerland
,
W Theiss
2   The Medizinische Klinik, Technische Universität Rechts der Isar, München, FRG
,
R Ritz
10   The Departement für Innere Medizin, Kantonsspital, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Received 25 April 1983

Accepted 11 July 1983

Publication Date:
18 July 2018 (online)

Summary

Thirty-three patients with acute iliofemoral thrombosis were randomly assigned to three treatment groups in a pilot doseranging study of thrombolytic therapy in deep vein thrombosis. One group received tissue culture urokinase in a dose of 2,200 I.U./kg/hr, and a second group in a dose of 1,100 I.U./kg/hr following a loading dose of 4,400 I.U./kg given in ten min. Urokinase was administered for 12 hr periods, alternating with 12 hr periods of heparin. A third group received an initial dose of 250,0001.U. of streptokinase in 20 min, followed by 100,000 I.U./hr. Treatment of all patients continued for three days. At the end of this period little improvement, evaluated by “blinded” interpretation of pre- and post-treatment phlebograms, was found in five out of ten of the higher-dose urokinase patients, seven out of eleven of lower-dosage urokinase patients, and six out of ten of streptokinase patients. Optional treatment for another three days showed little further improvement of urokinase-patients and moderate further improvement in the streptokinase-patients. – Neither of the 2 dosage schemes at intermittent application of urokinase appeared to be advantageous. Urokinase treated patients experienced fewer adverse reactions.

 
  • References

  • 1 Urokinase pulmonary embolism trial study group: Urokinase pulmonary embolism trial phase I results; a cooperative study. JAMA 1970; 214: 2163-2172
  • 2 Urokinase pulmonary embolism trial study group: Urokinase-streptokinase embolism trial phase 3 results; a cooperative study. JAMA 1974; 229: 1606-1613
  • 3 Browse NL, Thomas ML, Pim HP. Streptokinase and deep vein thrombosis. Br Med J 1968; 3: 717-723
  • 4 Kakkar VV, Flanc C, Howe CT, O’Shea M, Flute PT. Treatment of deep vein thrombosis. A trial of heparin, streptokinase and arvin Br Med J 1969; 1: 806-810
  • 5 Tsapogas MJ, Peabody RA, Wu KT, Karmody AM, Devaraj KT, Eckert Ch. Controlled study of thrombolytic therapy in deep vein thrombosis. Surgery 1973; 74: 973-984
  • 6 Seaman AJ, Common HH, Roesch J, Dotter CT, Porter JM, Lindell TD, Lawler WL, Schlueter WJ. Deep vein thrombosis treated with streptokinase or heparin. A randomized study Angiology 1976; 27: 549-553
  • 7 Groote Schuur Hospital thrombo-embolus study group: Streptokinase treatment for deep vein thrombosis. South Afr Med J 1977; 52: 709-713
  • 8 Marder VJ, Soulen RL, Atichartakarn V, Budzynski AZ, Parulekar S, Kim JR, Edward E, Zahavi J, Algazy KM. Quantitative venographic assessment of deep vein thrombosis in the evaluation of streptokinase and heparin therapy. Clin Med 1977; 80: 1018-1022
  • 9 Arnesen H, Heilo A, Ly B, Skaga E. A prospective study of streptokinase and heparin in the treatment of deep vein thrombosis. Acta Med Scand 1978; 203: 457-468
  • 10 Sharma GV R K, O’Connell DJ, Belko JS, Sasahara AA, Sherry S. (eds) Thrombosis and Urokinase, Proceedings of the Serono Symposia. Academic Press; New York: 1977. 9 181-184