Recombinant tissue‐type plasminogen activator is superior to streptokinase for local intra‐arterial thrombolysis

The results of local intra‐arterial thrombolysis in 98 patients treated with streptokinase and 69 patients treated with recombinant tissue plasminogen activator (rtPA) have been compared. The two groups of patients were well matched and their treatment protocols were identical except with regard to the thrombolytic agent used. Strict criteria for defining successful thrombolysis were used. Successful lysis was achieved in 40 of 98 patients (41 per cent) receiving streptokinase and 40 of 69 patients (58 per cent) receiving rtPA (P < 0.05). The time to lysis was significantly shorter with rtPA, median time 22h, than with streptokinase, median time 40 h ( P < 0.002). There was no diference in the incidence of haemorrhagic complications. These results suggest that rtPA is superior to streptokinase for local intra‐arterial thrombolysis.