Combined thrombectomy and isolated limb perfusion with streptokinase in the treatment of deep venous thrombosis.

A new mode of treatment for extensive acute and subacute deep venous thrombosis of the lower extremities combines the beneficial effects of surgical thrombectomy and of thrombolysis with streptokinase during the course of a single surgical intervention. Rapid-flow regional perfusion is the vehicle used to administer streptokinase and probably represents the third arm of this therapeutic approach by adding a hemodynamic washout effect. Because the thrombolytic agent is rinsed out of the circuit at the end of regional perfusion, the usual side effects and contraindications of this drug are avoided. Early and late results of this treatment are assessed clinically and with repeat phlebograms in a group of 6 unselected patients. Highly satisfactory results were achieved by 4 patients, 3 of whom experienced complete anatomic and functional restoration of deep veins along their entire length. Continued use of this method appears to be warranted.