Thrombolysis is an established and widely used clinical procedure for the removal of occlusive thrombi in acute myocardial infarction (AMI), ischemic stroke, peripheral occlusive artery disease (POAD), deep vein thrombosis (DVT) and pulmonary embolism. Streptokinase and recombinant tissue-type plasminogen activator (rt-PA) have dominated the market since their launches in 1977 and 1987, respectively.
There is general consensus that thrombolytic agents and therapy can be improved to further increase recanalization success rates in AMI above the current 80%. This has prompted the development of novel thrombolytic agents as well as new adjunctive therapies. The newer agents include structural analogs of rt-PA and urokinase, as well as other naturally-occurring or rationally designed plasminogen activators. Several are in Phase III clinical trials and may be approved and launched within two years.