Key messages

• Urokinase has a higher affinity for fibrin than streptokinase and causes direct activation of plasminogen to form plasmin and less systemic activation of plasminogen.

• Pulse fibrinolytic therapy is generally used in the short term, but longer infusion with lower doses may be used in venous thromboembolic disease and atypical venous thrombotic disorders.

• Intracerebral hemorrhage is the most feared complication of fibrinolytic therapy; it occurs in 0.5 to 1 per cent of cases and is likely to be fatal.

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Sleep Apnea

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