Objective: To observe the clinical efficacy and adverse reactions of recombinant human prourokinase (rhPro-UK) for catheter-directed thrombolysis (CDT) in treatment of acute iliofemoral deep venous thrombosis (DVT).
Methods: The clinical data of 66 patients with acute iliofemoral DVT undergoing CDT therapy from October 2016 to December 2018 were retrospectively analyzed. Of the patients, 33 cases underwent CDT with rhPro-UK (observation group), and the other 33 cases underwent CDT with urokinase (UK) (control group). The relevant clinical variables between the two groups of patients were compared. 
Results: There was no significant difference in general clinical features between the two groups of patients (all P>0.05) The thrombolytic rate (≥50%) in observation group was significantly higher than that in control group (81.8% vs. 60.6%, χ2=4.889, P<0.05), but no significant difference was noted in treatment effective rate between the two groups at hospital discharge (81.8% vs. 75.7%, χ2=4.889, P>0.05). No severe complications such as evident bleeding and anaphylactic reactions occurred in either group. 
Conclusion: Both rhPro-UK and UK are safe thrombolytic agents for acute iliofemoral DVT. The thrombolytic rate of rhPro-UK is superior to that of UK, but the long-term efficacy still needs to be further assessed.