Late thrombolysis with intracoronary streptokinase after myocardial infarction.

This patient had a myocardial infarction 4 years after coronary bypass grafting. Catheterization 1 month later revealed occlusion of the graft to the posterior descending by what appeared to be a clot. On each of 3 successive days, infusion of streptokinase accomplished recanalization of the graft. After the third treatment, he showed marked symptomatic improvement. Recanalization may be successful as late as 1 month after occlusion and repeated infusions of streptokinase over a period of days can be carried out safely and without loss of effectiveness.