What is the most effective lytic treatment for acute arterial thrombosis?

Urokinase is considered the most effective lytic treatment for acute arterial thrombosis due to its ability to directly convert plasminogen to plasmin, leading to the breakdown of fibrin and the dissolution of the clot. This thrombolytic agent has a rapid onset of action and is particularly useful in emergency situations where immediate restoration of blood flow is critical, such as in cases of acute limb ischemia.

In comparison to other options, while streptokinase is another thrombolytic agent, it is generally less specific and can lead to more immune-related side effects, making it a less preferred choice in certain clinical scenarios. Heparin, although effective as an anticoagulant, does not actively dissolve clots but instead prevents their growth and allows the body's natural fibrinolytic mechanisms to act. Warfarin, an oral anticoagulant, is used for long-term anticoagulation but is not suitable for acute thrombolysis as it takes longer to achieve therapeutic effects. Therefore, urokinase is favored in cases of acute arterial thrombosis for its effectiveness in rapidly lysing the clot.