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. 1971 Jun 19;2(5763):681–684. doi: 10.1136/bmj.2.5763.681

Comparison of Streptokinase and Heparin in Treatment of Isolated Acute Massive Pulmonary Embolism*

G A H Miller, G C Sutton, I H Kerr, R V Gibson, M Honey
PMCID: PMC1796248  PMID: 5556052

Abstract

Massive pulmonary embolism was confirmed by pulmonary arteriography in 23 patients. All were seen between 2 and 48 hours after the onset of embolism and none had pre-existing cardiorespiratory disease. Fifteen were treated with streptokinase and eight with heparin. Factors which might influence prognosis and rate of resolution were similar in the patients in each group, and there was no significant difference between the groups in terms of pretreatment haemodynamic or arteriographic findings. Haemodynamic and arteriographic findings after treatment for 72 hours provided an objective measurement of resolution, which was significantly greater in the streptokinase-treated patients. There was no mortality in either group, but treatment had to be changed in two heparin-treated patients because of clinical deterioration. The principal complication of treatment, seen more often in the streptokinase-treated patients, was bleeding from cut-down or operation sites.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARRITT D. W., JORDAN S. C. Clinical features of pulmonary embolism. Lancet. 1961 Apr 8;1(7180):729–732. doi: 10.1016/s0140-6736(61)92891-4. [DOI] [PubMed] [Google Scholar]
  2. BAUER G. CLINICAL EXPERIENCES OF A SURGEON IN THE USE OF HEPARIN. Am J Cardiol. 1964 Jul;14:29–35. doi: 10.1016/0002-9149(64)90101-8. [DOI] [PubMed] [Google Scholar]
  3. Chesterman C. N., Biggs J. C., Morgan J., Hickie J. B. Streptokinase therapy in acute major pulmonary embolism. Med J Aust. 1969 Nov 29;2(22):1096–1100. doi: 10.5694/j.1326-5377.1969.tb107628.x. [DOI] [PubMed] [Google Scholar]
  4. Dalen J. E., Banas J. S., Jr, Brooks H. L., Evans G. L., Paraskos J. A., Dexter L. Resolution rate of acute pulmonary embolism in man. N Engl J Med. 1969 May 29;280(22):1194–1199. doi: 10.1056/NEJM196905292802202. [DOI] [PubMed] [Google Scholar]
  5. Dickie K., de Groot W. Urokinase in pulmonary thromboembolic disease: a preliminary report. Tex Rep Biol Med. 1967 Winter;25(4):613–624. [PubMed] [Google Scholar]
  6. Genton E., Wolf P. S. Urokinase therapy in pulmonary thromboembolism. Am Heart J. 1968 Nov;76(5):628–637. doi: 10.1016/0002-8703(68)90161-0. [DOI] [PubMed] [Google Scholar]
  7. Hirsh J., Hale G. S., McDonald I. G., McCarthy R. A., Pitt A. Streptokinase therapy in acute major pulmonary embolism: effectiveness and problems. Br Med J. 1968 Dec 21;4(5633):729–734. doi: 10.1136/bmj.4.5633.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. MORRIS L. E., BALK P. THE MANAGEMENT AND MISMANAGEMENT OF ACUTE VENOUS THROMBOSIS (THROMBOPHLEBITIS) OF THE EXTREMITIES. Angiology. 1965 Jun;16:339–345. doi: 10.1177/000331976501600606. [DOI] [PubMed] [Google Scholar]
  9. Miller G. A., Gibson R. V., Honey M., Sutton G. C. Treatment of pulmonary embolism with streptokinase. A preliminary report. Br Med J. 1969 Mar 29;1(5647):812–815. doi: 10.1136/bmj.1.5647.812. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. ROBERTSON J. D., REID D. D. Standards for the basal metabolism of normal people in Britain. Lancet. 1952 May 10;1(6715):940–943. doi: 10.1016/s0140-6736(52)90543-6. [DOI] [PubMed] [Google Scholar]
  11. Sasahara A. A., Cannilla J. E., Belko J. S., Morse R. L., Criss A. J. Urokinase therapy in clinical pulmonary embolism. A new thrombolytic agent. N Engl J Med. 1967 Nov 30;277(22):1168–1173. doi: 10.1056/NEJM196711302772203. [DOI] [PubMed] [Google Scholar]
  12. Sautter R. D., Emanuel D. A., Fletcher F. W., Wenzel F. J., Matson J. I. Urokinase for the treatment of acute pulmonary thromboembolism. JAMA. 1967 Oct 16;202(3):215–218. [PubMed] [Google Scholar]
  13. Tow D. E., Wagner H. N., Jr, Holmes R. A. Urokinase in pulnonary embolism. N Engl J Med. 1967 Nov 30;277(22):1161–1167. doi: 10.1056/NEJM196711302772202. [DOI] [PubMed] [Google Scholar]
  14. Tow D. E., Wagner H. N., Jr Recovery of pulmonary arterial blood flow in patients with pulmonary embolism. N Engl J Med. 1967 May 11;276(19):1053–1059. doi: 10.1056/NEJM196705112761902. [DOI] [PubMed] [Google Scholar]
  15. WESSLER S., MORRIS L. E. Studies in intravascular coagulation. IV. The effect of heparin and dicumarol on serum-induced venous thrombosis. Circulation. 1955 Oct;12(4):553–556. doi: 10.1161/01.cir.12.4.553. [DOI] [PubMed] [Google Scholar]
  16. Wolf P. S., Genton E. The accuracy of pulmonary angiography in assessing resolution of experimental thromboemboli. Circulation. 1970 Jan;41(1):59–66. doi: 10.1161/01.cir.41.1.59. [DOI] [PubMed] [Google Scholar]

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