Abstract
The positive long-term effect with regard to prevention of post-thrombotic syndrome in invasive thrombolytic techniques has not been documented up to now. To investigate the development of a post-thrombotic syndrome, 250 patients with acute deep leg or iliac venous thrombosis were allocated randomly to five treatment groups and followed up over 8 - 10 years. Four treatment groups were given local regional thrombolysis with rt-PA (20 mg per day) or urokinase (100,000 I.U. daily) via a vein a vein on the dorsum of the foot over seven days in a standardized investigation schedule. One treatment group received 3 mio I.U. streptokinase per day systemically and a further treatment group received 5 mio I.U. urokinase i.v. per day. Follow-up compression treatment and oral anticoagulation was administered in all groups for one year. The patients were examined with regard to the development of post-thrombotic syndrome after one year, after two years, after four years, after five years and after 8 - 10 years. After one year, the group treated with systemic streptokinase showed significantly better recanalization in the region of the deep leg and iliac veins compared to the other treatment groups. After four years, 92 out of the 250 patients and after 8 - 10 years 54 out of the 250 patients could be followed up. It was shown in the follow-up investigations that fewer patients who underwent thrombolytic treatment and continued to apply compression treatment developed a post-thrombotic syndrome in fewer cases. The patients followed up showed increased pulmonary embolism and tumors.

Key words
Deep venous thrombosis of the leg, thrombolysis, post-thrombotic syndrome, compression treatment

Bibliografía del artículo

1. Comerota AJ, Aldridge SC. Thrombolytic therapy for deep venous thrombosis: a clinical review. Can J Surg 1993;36:359-64.
2. Widmer LK, Zemp E, Widmer MT, et al. Late results in deep vein thrombosis of the lower extremity. VAS 1985;14:264-68.

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