Hemorrhage, thrombolytic-induced

Lapchak PA, Chapman DF, Zivin JA (2000) Metalloproteinase inhibition reduces thrombolytic (tissue plasminogen activator)-induced hemorrhage after thromboembolic stroke. Stroke 31 3034-3040... 

Hemorrhage is the major risk of thrombolytic drugs there are some differences in risks between the various agents, and certain susceptibility factors can be identified. Transient hypotensive reactions have been described with all thrombolytic agents, but they are in principle reversible. Hypersensitivity reactions are most often seen in patients who have been treated with compounds derived from cultures of streptococci (streptokinase and anistreplase). Tumor-inducing effects have not been reported. 

The present results demonstrate that natural fibrolase exhibits effective in vivo thrombolytic activity in several animal thrombosis model systems. Infusion of the enzyme proximal to an occlusive thrombus induced rapid and specific thrombolysis in rabbit renal arterial and iliac venous thrombosis model systems. No evidence of hemorrhaging or alterations to the hemostatic system were observed in these studies. Additionally, no toxicity was observed and no angiographic, histologic, or functional evidence of side effects were obtained. The enzyme rapidly lysed 48 hr aged thrombi in the venous thrombosis model. This suggests that one of the primary mechanisms of thrombus resistance to PA-based agents. 

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