Fibrinolysin (Plasmin) Therapy in Acute Deep Thrombophlebitis: A Controlled Study

Sixty-two patients with deep thrombophlebitis of less than 10 days' duration were studied in controlled fashion. Thirty "control" patients were treated by routine methods including anticoagulant drugs. Thirty-two "treatment" patients received fibrinolysin (plasmin) in addition to control therapy. The composition of the groups studied and the protocol followed are presented in detail. Comparison of the 2 groups indicates that the addition of fibrinolysin to the therapeutic regimen leads to more rapid clearing of the acute phlebitic episode and may diminish the short-term incidence of phlebitic recurrence and pulmonary embolization. Postphlebitic residuals were encountered with almost equal frequency in both groups. Greater short-term differences in therapeutic response exist between control and fibrinolysin patients when analysis is restricted to those treated within 5 days of phlebitic onset. The available data do not permit firm conclusions regarding the apparently favorable influence of fibrinolysin upon the long-term prognosis of phlebitic subjects, but do indicate that recurrence and embolization can be expected in both groups. The factors that may influence the results obtained with fibrinolytic therapy are discussed and the importance of considering them in studies of this type is emphasized.

[1]  K. Moser.  Intravenous Administration of Fibrinolysin: Its Systemic Toxicity and Effect Upon Components of the Coagulation Mechanism , 1959, Angiology.

[2]  K. Moser.  Clinical Observations in Thromboembolic Disease Treated With Fibrinolysin , 1959, Angiology.

[3]  E. Cliffton.  The use of plasmin in humans. , 1959, Annals of the New York Academy of Sciences.

[4]  A. Fletcher,et al.  Fibrinolysis and fibrinolytic activity in man. , 1959, Physiological reviews.

[5]  A. Fletcher,et al.  Developments in fibrinolytic therapy for thrombo-embolic disease. , 1959, Annals of internal medicine.

[6]  Barker Wf.  The management of venous thrombosis and pulmonary embolism. , 1959, Surgery.

[7]  D. Deykin,et al.  Theory and Practice in Acute Venous Thrombosis: A Reappraisal , 1958, Circulation.

[8]  Stanfordwessler,et al.  Theory and Practice in Acute Venous Thrombosis , 1958 .

[9]  J. Sokal,et al.  Treatment of thrombosis with fibrinolysin (plasmin). , 1958, Journal of the American Medical Association.

[10]  K. Moser.  Thrombolysis with fibrinolysin (plasmin)-new therapeutic approach to thromboembolism. , 1958, Journal of the American Medical Association.

[11]  Von Kaulla Kn.  Safe dissolution of pathologic human fibrin deposits; a therapeutic challenge. , 1958 .

[12]  K. V. von Kaulla.  Intravenous Protein‐Free Pyrogen: A Powerful Fibrinolytic Agent in Man , 1958, Circulation.

[13]  K. V. Kaulla,et al.  Intravenous protein-free pyrogen; a powerful fibrinolytic agent in man. , 1958 .

[14]  G. Bauer.  Diagnosis and management of peripheral venous diseases. , 1957, The American journal of medicine.

[15]  F. Goldstein,et al.  The varied clinical manifestations of pulmonary embolism. , 1957, Annals of internal medicine.

[16]  E. Cliffton,et al.  THE USE OF PLASMIN IN HUMANS , 1957 .

[17]  N. Back,et al.  CLINICAL AND EXPERIMENTAL STUDIES ON FIBRINOLYTIC ENZYMES , 1957, Annals of the New York Academy of Sciences.

[18]  C. Crane.  Deep venous thrombosis and pulmonary embolism; experience with 391 patients treated with heparin and 126 patients treated by venous division, with a review of the literature. , 1957, The New England journal of medicine.

[19]  W. Tillett,et al.  Effects in Patients of Intravenous Infusions of Purified Streptokinase Preparations.∗ , 1957, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[20]  J. McLachlin,et al.  Observations on venous thrombosis. , 1956, A.M.A. archives of surgery.

[21]  T. Astrup,et al.  The biological significance of fibrinolysis. , 1956, Lancet.

[22]  T. Astrup.  Analytical Review: Fibrinolysis in the Organism , 1956 .

[23]  S. Cohen,et al.  The temporary thrombotic state; application of this concept to the therapy of recurrent thromboembolism, with bacteriologic and roentgenologic considerations in the differential diagnosis of pulmonary infarction and pneumonia. , 1956, The New England journal of medicine.

[24]  J. Byrne.  Phlebitis; a study of 748 cases at the Boston City Hospital. , 1955, The New England journal of medicine.

[25]  S. Wessler,et al.  Studies in intravascular coagulation. III. The pathogenesis of serum-induced venous thrombosis. , 1955, The Journal of clinical investigation.

[26]  W. Tillett,et al.  The intravenous infusion of the streptococcal fibrinolytic principle (streptokinase) into patients. , 1955, The Journal of clinical investigation.

[27]  R. I. Lowenberg,et al.  Early diagnosis of phlebothrombosis with aid of a new clinical test. , 1954, Journal of the American Medical Association.

[28]  C. Grossi,et al.  LYSIS OF THROMBI PRODUCED BY SODIUM MORRHUATE IN THE FEMORAL VEIN OF DOGS BY HUMAN PLASMIN (FIBRINOLYSIN) , 1954, Annals of surgery.

[29]  R. Mcfarland,et al.  Differences in calf circumference as diagnostic guide to thrombophlebitis. , 1953, Journal of the American Medical Association.

[30]  E. Cliffton,et al.  Fibrinolytic and proteolytic activity of a human plasminogen, prepared from fraction III of human plasma. , 1953, Journal of applied physiology.

[31]  P. Owren.  Prothrombin and accessory factors; clinical significance. , 1953, The American journal of medicine.

[32]  T. Astrup,et al.  The fibrin plate method for estimating fibrinolytic activity. , 1952, Archives of biochemistry and biophysics.

[33]  W. Tillett,et al.  THE LYSIS IN RABBITS OF INTRAVASCULAR BLOOD CLOTS BY THE STREPTOCOCCAL FIBRINOLYTIC SYSTEM (STREPTOKINASE) , 1952, The Journal of experimental medicine.

[34]  M. Debakey,et al.  Thrombo-embolism: an analysis of cases at the Charity Hospital in New Orleans over a 12-year period. , 1951, Annals of surgery.

[35]  R. Juergens.  [Pathogenesis and treatment of thrombosis]. , 1951, Revista medica de Chile.

[36]  B. B. Roe,et al.  Pulmonary embolism; a statistical study of post-mortem material at the Massachusetts General Hospital. , 1949, The New England journal of medicine.

[37]  W. Seegers,et al.  Two-stage procedure for the quantitative determination of prothrombin concentration. , 1949, American journal of clinical pathology.

[38]  E. Hines,et al.  The use of dicumarol as an anticoagulant; experience in 2,307 cases. , 1947, Annals of internal medicine.

[39]  J. Jorpes.  Anticoagulant Therapy in Thrombosis , 1946, Edinburgh medical journal.

[40]  Linton Rr.  Venous interruption in thromboembolic disease. , 1946 .

[41]  N. W. Barker,et al.  A Statistical Study of Postoperative Venous Thrombosis and Pulmonary Embolism. I. Incidence. in Various Types of Operations , 1941 .

[42]  J. Homans.  Venous thrombosis in the lower limbs: Its relation to pulmonary embolism , 1937 .

[43]  C. Rob.  Peripheral vascular diseases. , 1958, The Medical annual.

[44]  H. Bostrom,et al.  On the administration of heparin. , 1951, Acta chirurgica Scandinavica.

[45]  A. Allen.  Interruption of the deep veins of the lower extremities in the prevention and treatment of thrombosis and embolism. , 1947, Surgery, gynecology & obstetrics.

[46]  R. R. Linton.  Venous interruption in thromboembolic disease. , 1946, Surgery.