Technique and results of "higher-dose" infusion.

We experimented with thrombolytic technique in an attempt to maximize therapeutic outcome, selecting urokinase because of its proven safety and efficacy in clinical investigation. An initially "high-dose" regimen, starting at 4,000 U/min and decreasing to 1,000 U/min after restoration of antegrade blood flow, generally establishes lysis within 3-4 h--even after acute embolic or thrombolytic occlusion. It can also be used effectively and safely as a therapeutic trial. "High-dose" urokinase compares favorably with "low-dose" streptokinase and shows a lower incidence of bleeding and allergic complications.