Efficacy and Safety of Low-Dose Systemic Fibrinolytic Therapy for Acute Submassive Pulmonary Embolism

2021 ◽  
Vol 14 (7) ◽  
pp. 809
Author(s):  
Ahmet Güner ◽  
Ezgi Gültekin Güner ◽  
Seda Karakurt ◽  
Macit Kalçık
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Fibrinolytic Therapy ◽  
Efficacy And Safety ◽  
Submassive Pulmonary Embolism

scholarly journals Efficacy and safety of high dose versus low dose streptokinase for treatment of submassive pulmonary embolism

2011 ◽  
Vol 63 (2) ◽  
pp. 67-72 ◽  
Author(s):  
Ayman A. Abdelsamad ◽  
Ahmad S. El-Morsi ◽  
Ahmad E. Mansour
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
High Dose ◽  
Efficacy And Safety ◽  
Submassive Pulmonary Embolism

Controversial Fibrinolytic Therapy for Submassive Pulmonary Embolism Related to Right Heart Thrombus

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Eduardo Cavalcanti Lapa Santos ◽  
Diego Roberto Barbosa Pereira ◽  
Sergio Oliveira de Lima ◽  
Alexandre de Matos Soeiro ◽  
Maria Amellia do Rego Aquino ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Fibrinolytic Therapy ◽  
Right Heart ◽  
Submassive Pulmonary Embolism

scholarly journals EXTENDED ANTICOAGULANT THERAPYIN PATIENTS, WHO SURVIVED PULMONARY EMBOLISM

2018 ◽  
pp. 36-45
Author(s):  
Natalia M. Vorobieva ◽  
Elizaveta P. Panchenko
Keyword(s):  
Pulmonary Embolism ◽  
Anticoagulant Therapy ◽  
Low Dose ◽  
Oral Anticoagulants ◽  
Extension Study ◽  
Efficacy And Safety ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Recurrent Venous Thrombosis ◽  
Direct Acting

The review article discusses the options to extend anticoagulant therapy after completing the main anticoagulant therapy course in patients, who survived pulmonary embolism. It presents the results of randomized RE-MEDY and RE-SONATE studies of dabigatran, EINSTEIN-Extension study of rivaroxaban and AMPLIFY-Extension study of apixaban, which evaluated the feasibility, efficacy and safety of extended anticoagulant therapy with direct acting oral anticoagulants compared with placebo or warfarin. The article also provides the results of ASPIRE and WARFASA studies, which evaluated the possibility of using low-dose aspirin vs. Placebo for the extended treatment. The authors reviewed in details the results of einstein choice study, in which they compared the extended therapy with two doses of rivaroxaban (10 or 20 mg once a day) versus low (100 mg/day) doses of aspirin and against each other. The data obtained indicate that both doses of rivaroxaban significantly exceed aspirin in efficacy and reduce the risk of recurrent venous thrombosis by 74 and 66 %, respectively, without significantly increasing the risk of bleeding.

Low-Dose Alteplase for the Treatment of Submassive Pulmonary Embolism: A Case Series

2019 ◽  
Vol 33 (5) ◽  
pp. 708-711 ◽  
Author(s):  
Sara N. Layman ◽  
Tommie J. Guidry ◽  
Amanda R. Gillion
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricle ◽  
Low Dose ◽  
Case Series ◽  
Bleeding Events ◽  
Efficacious Treatment ◽  
Increased Risk ◽  
Submassive Pulmonary Embolism ◽  
Successful Resolution ◽  
Ventricle Size

Purpose: Pulmonary embolism (PE) can lead to significant morbidity and mortality. Thrombolytics are currently approved for the treatment of massive PE; however, the CHEST guidelines recommend against systemic thrombolytic use in acute PE patients without hypotension, unless these patients deteriorate on anticoagulation alone. Several studies have demonstrated the effectiveness of thrombolysis in submassive PE; however, the full thrombolytic dose resulted in significantly increased risk of non-intracranial bleeding and hemorrhagic stroke. The MOPETT trial demonstrated that low-dose tissue plasminogen activator (tPA) significantly reduced the risk of pulmonary hypertension and recurrent PE compared to anticoagulation alone in submassive PE patients without any bleeding events. Summary: This case series highlights 5 patient cases utilizing low-dose tPA for submassive PE. All patients had successful resolution of their symptoms and improvement in vitals and laboratory values. Furthermore, no patient had any bleeding during or after tPA administration. Three patients showed improved right ventricle function and reduced or normal right ventricle size on echocardiogram after tPA administration. Conclusion: The potential for low-dose tPA as a safe and efficacious treatment option for submassive PE is illustrated by this case series. However, larger, randomized controlled trials are needed to establish low-dose tPA as an accepted treatment modality.

Efficacy and Safety of Flow-Directed Pulmonary Artery Catheter Thrombolysis for Treatment of Submassive Pulmonary Embolism

2014 ◽  
Vol 202 (6) ◽  
pp. 1355-1360 ◽  
Author(s):  
Ron C. Gaba ◽  
Madhu S. Gundavaram ◽  
Ahmad Parvinian ◽  
M. Grace Knuttinen ◽  
Jeet Minocha ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Efficacy And Safety ◽  
Submassive Pulmonary Embolism ◽  
Catheter Thrombolysis

scholarly journals A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism

2015 ◽  
Vol 8 (10) ◽  
pp. 1382-1392 ◽  
Author(s):  
Gregory Piazza ◽  
Benjamin Hohlfelder ◽  
Michael R. Jaff ◽  
Kenneth Ouriel ◽  
Tod C. Engelhardt ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Multicenter Trial ◽  
Submassive Pulmonary Embolism
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