The Success Rate of Fibrinolytic Therapy in Fresh and Old Thrombosis of the Iliac and Femoral Veins

Since it is still a wide-held belief that fibrinolytic therapy can clear thrombi from deep veins only while they are fresh, we retrospectively analyzed the phlebographic results obtained in 85 patients with thrombosis of the iliac and/or femoral veins with symptoms present for 1 day to 8 weeks prior to treatment. Streptokinase, urokinase, or both drugs successively were administered in these patients for a mean of 9 days (range: 2 to 26 days). Complete or partial resolution of the thrombotic occlusion was obtained in 94%, 82%, and 69%, respectively, in those patients who presented within 3 days, 1 to 2 weeks, and 3 to 4 weeks after the first appearance of symptoms. With a delay of 5 to 8 weeks the results were uniformly poor with only 1 partial recanalization in 7 patients.