Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1968 Dec 21;4(5633):729-732-2, 733-734. doi: 10.1136/bmj.4.5633.729

Streptokinase Therapy in Acute Major Pulmonary Embolism: Effectiveness and Problems

J Hirsh, G S Hale, I G McDonald, R A McCarthy, A Pitt
PMCID: PMC1912872  PMID: 5723724

Abstract

Eighteen patients with major pulmonary embolism were treated with streptokinase infused by a catheter or given intravenously. Fourteen showed clinical improvement and 12 out of 16 patients investigated showed definite angiographic improvement after 24 to 48 hours of treatment with streptokinase. The angiographic improvement following streptokinase contrasted with the lack of this in three patients after 24 hours of heparin treatment.

Resolution following streptokinase therapy was most noticeable in patients treated shortly after a single embolic episode, and was least marked in those with recurrent embolism complicated by associated cardiac or pulmonary disease. Of the four patients who failed to improve, two died and two had pulmonary embolectomy and survived.

The results suggest that streptokinase therapy is practicable provided that adequate laboratory control is available, and that it hastens early resolution in acute major pulmonary embolism.

Full text

PDF
729

Images in this article

732-2Fig. 4
on p.732-2
732-2Fig. 5
on p.732-2
732-1Fig. 1
on p.732-1
732-1Fig. 2
on p.732-1
732-1Fig. 3
on p.732-1

Selected References

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

  1. BROWSE N. L., JAMES D. C. STREPTOKINASE AND PULMONARY EMBOLISM. Lancet. 1964 Nov 14;2(7368):1039–1043. doi: 10.1016/s0140-6736(64)90991-2. [DOI] [PubMed] [Google Scholar]
  2. Chait A., Summers D., Krasnow N., Wechsler B. M. Observations on the fate of large pulmonary emboli. Am J Roentgenol Radium Ther Nucl Med. 1967 Jun;100(2):364–373. doi: 10.2214/ajr.100.2.364. [DOI] [PubMed] [Google Scholar]
  3. Emanuel D. A., Sautter R. D., Wenzel F. J. Conservative treatment of massive pulmonary embolism. JAMA. 1966 Sep 12;197(11):924–926. [PubMed] [Google Scholar]
  4. Fred H. L., Axelrad M. A., Lewis J. M., Alexander J. K. Rapid resolution of pulmonary thromboemboli in man. An angiographic study. JAMA. 1966 Jun 27;196(13):1137–1139. [PubMed] [Google Scholar]
  5. Genton E., Wolf P. S. Experimental pulmonary embolism: effects of urokinase therapy on organizing thrombi. J Lab Clin Med. 1967 Aug;70(2):311–325. [PubMed] [Google Scholar]
  6. HOLLISTER L. E., CULL V. L. The syndrome of chronic thrombosis of the major pulmonary arteries. Am J Med. 1956 Aug;21(2):312–320. doi: 10.1016/0002-9343(56)90064-x. [DOI] [PubMed] [Google Scholar]
  7. Hirsh J., Hale G. S., McDonald I. G., McCarthy R. A., Cade J. F. Resolution of acute massive pulmonary embolism after pulmonary arterial infusion of streptokinase. Lancet. 1967 Sep 16;2(7516):593–597. doi: 10.1016/s0140-6736(67)90741-6. [DOI] [PubMed] [Google Scholar]
  8. JOHNSON A. J., McCARTY W. R. The lysis of artificially induced intravascular clots in man by intravenous infusions of streptokinase. J Clin Invest. 1959 Sep;38:1627–1643. doi: 10.1172/JCI103941. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. O'Sullivan E. F., Hirsh J., McCarthy R. A., de Gruchy G. C. Heparin in the treatment of venous thrombo-embolic disease: administration, control and results. Med J Aust. 1968 Jul 27;2(4):153–159. doi: 10.5694/j.1326-5377.1968.tb29378.x. [DOI] [PubMed] [Google Scholar]
  10. ORELL S. R. The fate and late effects of non-fatal pulmonary emboli. Acta Med Scand. 1962 Oct;172:473–484. doi: 10.1111/j.0954-6820.1962.tb07181.x. [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., Wenzel F. J. Treatment of acute massive pulmonary embolism. Medical or surgical? Ann Thorac Surg. 1967 Aug;4(2):95–105. doi: 10.1016/s0003-4975(10)66485-5. [DOI] [PubMed] [Google Scholar]
  13. TILLETT W. S., JOHNSON A. J., McCARTY W. R. The intravenous infusion of the streptococcal fibrinolytic principle (streptokinase) into patients. J Clin Invest. 1955 Feb;34(2):169–185. doi: 10.1172/JCI103071. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Thomas D. P. Treatment of pulmonary embolic disease. A critical review of some aspects of current therapy. N Engl J Med. 1965 Oct 21;273(17):885–892. doi: 10.1056/NEJM196510212731701. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Verstraete M., Vermylen J., Amery A., Vermylen C. Thrombolytic therapy with streptokinase using a standard dosage scheme. Br Med J. 1966 Feb 19;1(5485):454–456. doi: 10.1136/bmj.1.5485.454. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES