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The difficulty is known to determin the real date of the beginning of venous thrombosis. Acute deep thrombosis of the femoral and pelvic veins can be followed by two severe complications: pulmonary embolism and chronic venous insufficiency. Primarily causal treatment has to be aspired: thrombectomy or thrombolysis. Confrontation of two groups: 34 successfully thrombolysed occlusions with streptokinase (SK) contrary to 34 heparin treated occlusions without success. Control 3 years later: clear-cut advantage of thrombolytic therapy. Evaluation of 93 patients in a study over ten years with acute, deep venous thrombosis of the extremities after SK treatment: success rate 68%. Comment on the situation of acute postoperative thrombosis with the possibility of thrombolytic treatment based on our experimental examinations. In summary, it can be stated that thrombolytic treatment cannot be started before the seventh postoperative day without risk of hemorrhage. Side effects respectively complications of SK treatment have to be mentioned like febrile reactions and hemorrhages. Fever appeared in 57% of the patients in a large study, hemorrhaging in 29% of the cases, 22% of which could be considered mild. Pulmonary embolism during thrombolysis occured in 4-8%, 1-2% lethal. An over-all lethality rate for SK therapy in the mentioned study is between 1, 2 to 1, 4%.

Thrombolytic Therapy with Streptokinase in Acute Deep Venous Thrombosis