Because of its fibrinolytic action,
streptokinase is believed to reduce the severity of the
postthrombotic syndrome in patients with
deep vein thrombosis. A prospective and a retrospective study have been undertaken in an attempt to determine when this
therapy is useful for patients with
deep vein thrombosis. The prospective study included 15 patients with
deep vein thrombosis: 5 were treated in the hospital with
streptokinase and
heparin and 5 only with
heparin, 5 were treated at home with only
phenprocoumon. All the patients received oral
anticoagulant therapy for at least 6 months. Three to four months after the acute episode, phlebography and venous pressure measurements were carried out.
Streptokinase appeared to give the best results but with more side-effects. In the retrospective study, 51 patients who had had
deep vein thrombosis in 1969 were reexamined 31-47 months later. It was found that more than 50% of the patients with a
thrombosis in the femoral and/or iliac vein developed a severe
postthrombotic syndrome, in contrast to only 9% of those with a
thrombosis in the popliteal vein or lower. It is recommended, on the basis of both the prospective and the retrospective study, that patients with a
thrombosis in the femoral and/or iliac vein should be treated with either
heparin or
streptokinase during the early stage. It is probable that
streptokinase will significantly decrease the frequency and severity of the
postthrombotic syndrome in these patients in particular, although this has not yet been proven.