Thrombolytic therapy in thrombosis.

A NATIONAL INSTITUTES OF HEALTH Consensus Development Conference, held at NIH April 10-12, 1980, addressed the issue of thrombolytic therapy* for the management of acute deep-vein thrombosis and pulmonary embolism. At NIH, consensus development conferences bring together biomedical research scientists, practicing physicians, consumers, and others as appropriate in an effort to reach general agreement on the safety and effectiveness of a medical technology. That technology may be a drug, device, or medical or surgical procedure. A consensus development panel, after listening to expert presentations at the NIH conference on Thrombolytic Therapy in Thrombosis, issued the following consensus statement: For over 3 decades, the primary method of therapy used by almost all physicians for the management of acute deep-vein thrombosis and pulmonary embolism has been anticoagulation. This form of therapy has become so ingrained in medical practice that physicians, while still concerned over the bleeding risk associated with the use of anticoagulants, nevertheless seem secure in the belief that they are providing optimal, if not ideal, therapy for these disorders. With the advent of thrombolytic therapy, this is no longer true for a large number of cases. Anticoagulation for the management of acute deep-vein thrombosis and pulmonary embolism, while usually effective in preventing or slowing further thrombus formation in veins and significantly diminishing the likelihood of subsequent or recurrent embolization, does not: