Streptokinase (SK) arterial infusion has become an increasingly used method in the therapy of peripheral arterial occlusive disease. Dosage regimens and durations of therapy are extremely variable. The degree of alteration in the coagulation system has not been adequately addressed. Such alterations might have profound significance regarding patient selection, nature of contraindica tions and degree of toxicity. We have systematically studied the effects of very low doses of SK given intra-arterially in peripheral arterial occlusive disease states. Our detailed studies demonstrate a profound systemic effect on the clot ting mechanism and function in such patients with marked lowering of fibrino gen, depletion of plasminogen and overall hypocoagulability. The effects of these findings on the clinical aspects of this therapeutic technique are discussed.
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