Streptokinase vs Heparin for Deep Venous Thrombosis

Sidorov, Jaan

doi:10.1001/archinte.1989.00390080097022

Cited by 14 publications

(1 citation statement)

References 41 publications

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“…Studies have been performed in which early lysis had a better clinical outcome than stabilization with heparin [23]. However, because of a high incidence of life-threatening bleeding complications, thrombolysis to prevent PTS cannot be recommended yet [24,25].…”

Section: Discussionmentioning

confidence: 99%

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

et al. 1998

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1. The purpose of the study was to evaluate the degree of thrombus regression, development of valvular insufficiency, impaired calf muscle pump function and clinical symptoms after a period of acute deep venous thrombosis. 2. Seventy patients with acute deep venous thrombosis, diagnosed by duplex scanning or venography, received treatment with heparin and oral coumarin derivatives according to a standard protocol. All patients wore graduated compression stockings during the whole study period. Duplex scanning was performed at diagnosis and 1 and 3 months later to measure thrombus mass and reflux. The supine venous pump function test was used to assess calf muscle pump function. 3. Three months follow-up was completed in 60 patients. In total 218 (28%) out of 780 vein segments were initially thrombosed and 134 (17%) could not be traced. A statistically significant reduction of thrombus mass was recorded throughout the study period. Total resolution of thrombosis in all vein segments occurred in 25% of the patients within 1 month and in 40% in 3 months. There was no difference in regression between the various proximal vein segments. Distal segments showed more regression than proximal segments. Reflux occurred in 27% of the initially thrombosed veins and in 15% of the patent veins. Patients who showed total resolution after 1 month had a significantly higher calf muscle pump function than patients without total resolution (70%pf vs 61%pf, P < 0.05). Patients with reflux in two or more segments had a significantly lower calf muscle pump function than patients with reflux in less than two segments (58%pf vs 69%pf, P < 0.05). 4. Using duplex scanning and the supine venous pump function test 3 months after an acute deep venous thrombosis, overall haemodynamic abnormalities and local site of valve incompetence could readily be identified. Patients with haemodynamic abnormalities might be at risk to develop the post-thrombotic syndrome. There was no difference in thrombus regression between the various proximal vein segments. Reflux was significantly more often seen in initially thrombosed veins. Thirty-five percent of the patients developed an abnormal calf muscle pump function after 3 months. Patients with early resolution of thrombus had a higher calf muscle pump function after 3 months.

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Section: Discussionmentioning

confidence: 99%

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

et al. 1998

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Thrombolytic Agents: Balancing Cost, Efficacy, and Side Effects

Marder

1990

Clinical Cardiology

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Balancing the benefits, risks, and cost of thrombolytic treatment is a complex issue which depends considerably upon the variable threat of the thrombus to organ physiology and patient survival. For example, after deep vein thrombosis (DVT), the major risk is long‐term disability due to the postphlebitic syndrome, while in pulmonary embolism (PE) patients, the risks concern short‐term mortality and impaired pulmonary physiology. Thus, for treating DVT or PE, the question is whether thrombolytic therapy would be valuable in addition to other antithrombotic approaches. Clearly, the best indication for thrombolytic therapy is in acute myocardial infarction (MI) patients, because this therapy has the potential for reducing coronary artery thrombus mortality. In acute MI the major issues concern the choice of thrombolytic agent and the relative merits of nonpharmacologic interventions such as angioplasty and bypass surgery. An optimal window of treatment opportunity exists for all of the indications. The window is shortest for MI, intermediate for PE, and longest for DVT patients.

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Deep Venous Thrombosis

Bounameaux¹

2001

Handbook of Experimental Pharmacology

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Streptokinase vs Heparin for Deep Venous Thrombosis

Cited by 14 publications

References 41 publications

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

Thrombolytic Agents: Balancing Cost, Efficacy, and Side Effects

Deep Venous Thrombosis

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