Response of an abdominal aortic thrombotic occlusion to local low-dose streptokinase therapy.

Local low-dose streptokinase infusion (5000 to 6000 IU/hr) as compared to systemic streptokinase infusion (loading dose 250,000 IU/hr, maintenance dose 100,000 IU/hr) successfully relieved a total thrombotic abdominal aortic occlusion. No complications of bleeding or distal embolization occurred during streptokinase therapy, which required only 8 days of hospitalization. When seen at 4 months after streptokinase infusion, the patient was still free of symptoms. When no immediate threat of ischemic limb loss exists, streptokinase may offer a promising therapeutic alternative to surgical intervention for patients who represent a poor operative risk.