Streptokinase therapy was used in 16 patients with severe ischemia of the limbs with undetectable ankle or wrist pressures. All patients had symptoms at rest with neurological deficits and the thrombolysis was considered an alterna tive to amputation. Limb salvage was achieved in 13 patients with 15 usages. Thrombolytic therapy was useful primarily as an adjunct to surgical therapy and was effective in lysing clots in small arteries not amenable to surgical methods. Thrombolysis was effective in relieving ischemic pain and in restor ing pedal pulses in most instances. Streptokinase was used safely preopera tively, intraoperatively and postoperatively.
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