Transcatheter intracavitary fibrinolysis of infected extravascular hematomas

Transcatheter thrombolysis of embolic and thrombotic vascular occlusion has been successfully used in the past several years in a wide variety of applications. Both streptokinase and urokinase are effective in this regard, although urokinase has recently become the agent of choice in many centers, including our own. Fibrinolytic agents have also been used successfully outside the vascular system (in the pleural space) for treatment of hemothorax and empyema. This therapy was used primarily in the 1950s, although there have been sporadic reports of intrapleural fibrinolytic therapy in the recent literature. There is, however, little reference to this body of work in the radiologic literature and we are not aware of the application of fibrinolytic therapy to infected hematomas in the abdomen. We report here the successful use of transcatheter fibrinolysis in the treatment of infected intraabdominal postsurgical hematomas in two patients.