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In patients with chronic renal insufficiency undergoing chronic hemodialysis or heme— filtration, shunts uith great blood flous are always needed. In the past feu years ue have preferred Brescia-Cimino shunts (BCS). As there are only a feu arteries and veins, from uhich shunts are able to be formed, ue aluays try to save clotted shunts. Ide have performed thrombolytic therapy uith StreptokinaseR 24 times. Immediately following the clotting of a BCS ue began hemodialytic treatment for about 10-12 hours. Afterwards, according to the ASTK titres, an initial dose of StreptokinaseR uas applied; this uas folloued by continuous doses of about 100,000 units/hour. If another hemodialytic treatment uas necessary before reopening the shunt, ue started this only after 3 days uith a reduced dose of StreptokinaseR (50% of the original amount). In 22 cases this thrombolytic therapy uas successful uithin 3-120 hours, in 2 cases the shunts remained clotted. In three of the successfully treated patients, the shunts had been clotted for 19, 28 and 40 days. Ide believe that thrombolytic therapy uith StreptokinaseR in patients uith clotted BCS has proven to be successful and dependable.

Treatment of Clotted Brescia-Cimino-Shunts by Thrombolytic Therapy with Streptokinaser