thrombolysis for pulmonary embolism

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Indications

Contraindications

  • high risk of bleeding
  • age is not a contraindication[1]
  • comordidites are not a contraindication[1]

Clinical significance

Procedure

* use full dose thrombolytic agent

* 1/2 dose alteplase associated with additional thrombolytic therapy or mechanical thrombectomy[5]

Notes

More general terms

Additional terms

References

  1. Jump up to: 1.0 1.1 1.2 1.3 1.4 Stein PD, Matta F. Treatment of unstable pulmonary embolism in the elderly and those with comorbid conditions. Am J Med. 2013;126(4):304-310 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23415054
    Dalen JE. Editorial: Thrombolytics decrease mortality in elderly patients with unstable pulmonary embolism. Am J Med. 2013;126(4):278-279 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23369210
  2. Sharifi M et al. Moderate pulmonary embolism treated with thrombolysis (from the "MOPETT" trial). Am J Cardiol 2013 Jan 15; 111:273. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23102885
  3. Meyer G et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 2014 Apr 10; 370:1402. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24716681 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1302097
  4. Jump up to: 4.0 4.1 Chatterjee S et al Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage. A Meta-analysis. JAMA. 2014;311(23):2414-2421 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24938564 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1881311
    Beckman JA Thrombolytic Therapy for Pulmonary Embolism. JAMA. 2014;311(23):2385-2386 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24938561 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1881294
  5. Jump up to: 5.0 5.1 Kiser TH, Burnham EL, Clark B et al. Half-dose versus full-dose alteplase for treatment of pulmonary embolism. Crit Care Med 2018 Jul 2; PMID: https://www.ncbi.nlm.nih.gov/pubmed/29979222 https://insights.ovid.com/crossref?an=00003246-900000000-96212