Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

Summary

Treatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

• References

• 1 Allington M. J. The latex flocculation inhibition test for the detection of fibrin(ogen) degradation products. Scandinavian Journal of Haematology 1971; Suppl 13 p. 115
• 2 Davies J. A, Merrick M. V, Sharp A. A, Holt J. M. Controlled trial of ancrod and heparin in treatment of deep vein thrombosis of lower limb. Lancet 1972; 1: 113
• 3 Dhall D. P, Walker M. G, Mavor G. E. Factors in rethrombosis. Postgraduate Medical Journal 1973; 49 Suppl. 5 34
• 4 Duckert F, Müller G, Nyman D, Benz A, Prisender S, Madar G, Da Salva M. A, Widner L. K, Schmitt H. E. Treatment of deep vein thrombosis with streptokinase. British Medical Journal 1975; 1: 479
• 5 Ehringer H, Dudczak R, Lechner K. A new approach in the treatment of peripheral arterial occlusions: defibrination with Arvin. Angiology 1974; 25: 279
• 6 Forbes G. D, Prentice C. R. M, Barbarell J, Thomson C. Sequential therapy with anerod followed by streptokinase for thrombotic disorders. IVth International Congress on Thrombosis and Haemostasis. Vienna; Austria: (Abstracts) 1973. p. 414
• 7 Kakkar V. V, Flanc C, Howe C. T, O’Shea M, Flute P. T. Treatment of deep vein thrombosis. A trial of heparin streptokinase and Arvin. British Medical Journal 1969; 1: 806
• 8 Lea Thomas M, McAllister V, Tonge K. Simplified phlebography in deep vein thrombosis. Clinical Radiology 1971; 22: 490
• 9 Moser K. M, Hajjar C. The combined use of fibrinolytic and anticoagulant agents. American Journal of Cardiology 1960; 6: 496
• 10 Pitney W. R, Raphael M. J, Webb-Peploe M. M, Olsen E. G. J. Treatment of experimental venous thrombosis with streptokinase and ancrod. British Journal of Surgery 1971; 58: 442
• 11 Rahimtoola S. H, Raphael M. J, Pitney W. R, Olsen E. J. G, Webb-Peploe M. Therapeutic defibrination and heparin therapy in the prevention and resolution of experimental venous thrombosis. Circulation 1970; 42: 729
• 12 Sharp A. A, Eggleton M. J. Haematology and the extracorporeal circulation. Journal of Clinical Pathology 1963; 16: 551
• 13 Sharp A. A, Howie B, Biggs R, Methuen D. T. Defibrination syndrome in pregnancy. Value of various diagnostic tests Lancet 1958; 2: 1309
• 14 Tibbutt D. A, Chesterman C. N, Sharp A. A. Side effects of therapy with streptokinase. To be submitted for publication 1976
• 15 Tibbutt D. A, Williams E. W, Walker M. W, Chesterman C. N, Holt J. M, Sharp A. A. Controlled trial of ancrod and streptokinase in the treatment of deep vein thrombosis of lower limb. British Journal of Haematology 1974; 27: 407