The use of thrombolytic agents to dissolve intravascular thrombi is surging beyond its previous confines. In the mid-1960s, uncontrolled studies in patients with pulmonary embolism were sufficiently impressive for the National Heart, Lung, and Blood Institute to undertake controlled trials. Sharma et al1 have recently summarized the two major trials of the 1970s that demonstrated that thrombolytic agents were effective in the short-term and long-term treatment of pulmonary embolism. Studies in deep-venous thrombosis have shown that thrombolytic therapy not only more rapidly resolves thrombi than does heparin sodium in this setting, but it also preserves the integrity of the valves of the involved veins.2 The controversy regarding direct perfusion of recently thrombosed coronary arteries with streptokinase in patients with acute myocardial infarction continues, with two recent prospective randomized trials reaching opposite conclusions.3,4
See also p 159.
Given the wealth of information indicating that thrombolytic therapy is superior