Massive pulmonary embolism: short-term effects of thrombolytic treatment

• Published in: Angiology Vol. 37; no. 11; p. 832
• Main Authors: Grau, E, Fontcuberta, J, Pagés, M A, Martinez, R, Félez, J, Net, A, Rutllant, M L
• Format: Journal Article
• Language: English
• Published: United States 01.11.1986
• Subjects: Acute Disease; Adult; Aged; Angiography; Female; Fibrinolytic Agents - therapeutic use; Humans; Lung - blood supply; Male; Middle Aged; Pulmonary Embolism - drug therapy; Streptokinase - adverse effects; Streptokinase - therapeutic use; Urokinase-Type Plasminogen Activator - adverse effects; Urokinase-Type Plasminogen Activator - therapeutic use
• ISSN: 0003-3197
• DOI: 10.1177/000331978603701107

This study assessed the short-term effects of thrombolytic treatment in 38 patients with massive pulmonary embolism. Thirty-two were treated with streptokinase and six with urokinase. Intrapulmonary artery instillation of fibrinolytic agents was utilized except in 3 patients. There was a marked hemodynamic and arteriographic improvement (p less than 0.0005) in 33 patients (86.8%). Four patients (10.5%) died because of treatment failure. In these cases the fibrinogen concentration remained above 1 gr/liter during therapy. Bleeding was detected in 22 patients (57.8%) but was most often related to puncture or cut-down sites, and only 2 patients (5.2%) had major bleeding. One patient (2.6%) had cerebral hemorrhage. It is concluded that "classic" thrombolytic treatment is to be chosen in life-threatening pulmonary embolism. However, the difficulties sometimes encountered in producing an intense lytic effect and its low fibrinolytic specificity for the thrombus do not permit the obtainment of better results.