Use of Fibrinolysin (Thrombolysin) in Isolated Limb Perfusion to Dissolve Arterial Thrombi

Introduction  Surgical therapy in the management of acute peripheral arterial obstruction is often unsatisfactory, due to distal propagation of the thrombus or thrombosis of vital collateral channels. Drugs are available at the present time which will lyse fresh vascular thrombi. Although confusion exists as to which enzyme is the preferred clot-lysing agent, fibrinolysin (plasmin) has been demonstrated to be effective in many experimental and clinical conditions.^1,3,6 Evidence is accumulating, however, which indicates that some sort of local administration is necessary for fibrinolysin to be effective within its toxic limitation.Boyles² has shown that intra-arterial administration of fibrinolysin is necessary for the lysis of coronary and carotid artery thrombosis. Cliffton³ has obtained more effective results in the treatment of acute thromboembolism in humans by the direct injection of fibrinolysin. Ouchi⁷ claims dissolution of clots up to 7 days in age by the local administration of fibrinolysin.Kierle