Radiology, Vol 154, 75-77, Copyright © 1985 by Radiological Society of North America

ARTICLES

Streptokinase therapy: complications of intra-arterial use

EK Lang

An inordinately high rate of renal complications was encountered among 35 patients treated for thrombotic or thromboembolic occlusion of the leg by injection of streptokinase into a bypass graft or native artery. Five patients demonstrated massive myoglobinuria following restoration of flow to ischemic and necrotic tissues; acute tubular necrosis developed in 2 of them, and 1 patient died as a result of renal shutdown, electrolyte imbalance, hypofibrinogenemia, and mediastinal and retroperitoneal hemorrhage. Massive myoglobinuria was also noted in 5 out of 13 patients with compartment syndrome but no evidence of ischemic necrosis. This complication could be lessened by fasciotomy and resection of the upper third of the fibula. Although myoglobinuria and complications such as acute tubular necrosis are only rarely reported, they are not unexpected following muscular ischemia. Attempts to salvage irreparably damaged tissues by re-establishing circulation appear to carry an unacceptably high risk of renal complications and may even threaten the life of the patient.

This article has been cited by other articles:

				C. Delcour, B. Bellens, G. Vandenbosch, J.P. Dereume, and J. Struyven Long-Term Follow-Up of Intraarterial Infusion of Streptokinase in Acute Lower Limb Ischemia Vascular and Endovascular Surgery, September 1, 1987; 21(5): 339 - 343. [Abstract] [PDF]