Successful Intravenous Streptokinase Therapy in Refractory Extensive Deep Vein Thrombosis Associated with Inferior Vena Cava Agenesis: A Novel Treatment for a Rare Case

With the diagnosis of IVC agenesis and extensive bilateral DVT, the case was treated with heparin and warfarin, but there was not a considerable response in ultrasound evaluation and symptoms. There is no evidence of pulmonary embolism, and the vital signs were stable. Then the treatment with streptokinase (250,000 IU within 30 min followed by 100,000 IU/h for 72 h, intravenous infusion) was started. After a few days, symptom resolved. At the final ultrasound examination, recanalized DVT was reported. Life‐long treatment with oral anticoagulant was recommended.