Urokinase Efficacy for Deep Vein Thrombosis Developing During Streptokinase Therapy—A Case Report

Abstract

A patient with embolic occlusion of the right femoral artery and the left tibial arteries received streptokinase as treatment to lyse the emboli. Blood flow in both lower extremities improved with streptokinase administration. On the fourth day of therapy, however, the patient developed pain and swelling of the right calf. A venogram confirmed the presence of a clot obstructing the right popliteal vein. Streptokinase infusion was stopped, and urokinase infusion was started. Pain and swelling in the right calf disappeared and venous blood flow was greatly improved during urokinase therapy. Urokinase infusion was stopped after sixty hours, and heparin therapy was started. The patient was discharged from the hospital one month after admission. Patients should be closely monitored during thrombolytic therapy to detect any signs of complica tions, including new thrombotic episodes.