Catheter-induced superior vena cava thrombosis-lysis with streptokinase and apsac (Anisoylated plasminogen streptokinase activator complex BRL 26921)

Ten patients were given thrombolytic therapy for obstructive thrombi in the superior vena cava (SVC) following catheterisation for total parenteral nutrition (TPN—8 cases) or chemotherapy (2 cases). Seven of the TPN patients were given intravenous APSAC (Beecham, BRL 26921); the other 3 were given streptokinase (SK). Five of the caval occlusions treated with APSAC cleared after between 1 and 5 doses; one of those given SK cleared after 3 days continuous infusions during which active thrombolytic potential was maintained.Intravenous APSAC should be considered for the relief of major SVC occlusive thrombosis secondary to central venous catheters.