[New methods of thrombolysis]

Abstract

Different possibilities of clinical thrombolysis are described. The classical therapy with streptokinase has the disadvantages of antigenicity and of a considerable influence on the clotting system. For this reason new methods of thrombolysis were examined. Urokinase, plasmin and t-PA are physiological substances and have, therefore, no antigenicity. However, plasmin also has a considerable influence on the clotting system whilst coagulation is only moderately influenced by urokinase. This necessitates additional administration of heparin when the dose of urokinase is low. t-PA is adsorbed onto the fibrin clot in the same manner as plasminogen. Thereby both substances acquire a considerably higher affinity for each other. In addition, inactivation by physiological inhibitors is considerably diminished after adsorption. This causes an almost exclusive lysis of the clot without alterations of systemic coagulation. Clinical results after application of the newer thrombolytic drugs are presented.