scholarly journals Massive and Submassive Pulmonary Embolism: Diagnostic Challenges and Thrombolytic Therapy

2014 ◽  
Vol 21 (2) ◽  
pp. 208-210
Author(s):  
Anand Swaminathan
2013 ◽  
Vol 84 (1) ◽  
pp. 62 ◽  
Author(s):  
Yun-Ju Cho ◽  
So-My Koo ◽  
Duk Won Bang ◽  
Ki-Up Kim ◽  
Soo-taek Uh ◽  
...  

2016 ◽  
Vol 83 (12) ◽  
pp. 923-932
Author(s):  
Ali Ataya ◽  
Jessica Cope ◽  
Abbas Shahmohammadi ◽  
Hassan Alnuaimat

2015 ◽  
Vol 3 (4) ◽  
Author(s):  
Lexin Wang

Pulmonary embolism is a common disease that is associated with significant mobility and mortality. Thrombolysis is potentially life saving when used in conjunction with anticoagulant therapy. Indications for thrombolysis for pulmonary embolism are not well defined. In patients with acute massive pulmonary embolism and hypotension, thrombolytic therapy offers some benefits in terms of mortality reduction. The use of thrombolysis in patients with stable haemodynamics has been controversial for more than two decades. Recent clinical studies have indicated that thrombolytic treatment in conjunction with heparin in patients with submassive pulmonary embolism and normal blood pressure can prevent deterioration of the disease and diminish the need for more intensive therapies during hospitalisation. The role of prehospital thrombolytic therapy for acute pulmonary embolism is unclear and further clinical studies are warranted.


2007 ◽  
Vol 50 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Andrew Worster ◽  
Camala Smith ◽  
Shawna Silver ◽  
Michael D. Brown

2018 ◽  
Vol 33 (1) ◽  
pp. 74-89 ◽  
Author(s):  
Lauren A. Igneri ◽  
John M. Hammer

Objective: To critically evaluate the published literature assessing the safety and efficacy of thrombolytic therapy for massive and submassive pulmonary embolism (PE). Methods: A search of human trials in the English-language (September 2017) was conducted through the MEDLINE database using the following terms: PE, tissue plasminogen activator, tenecteplase, and alteplase. 67 unique articles were identified, of which 24 clinical trials discussing clinical outcomes related to administration of either intravenous tenecteplase or alteplase were included. Results: Thrombolytic therapy with anticoagulation significantly reduced mortality compared to anticoagulation alone in massive PE. In submassive PE, thrombolytics reduced the rate of right ventricular dysfunction and hemodynamic collapse; however, there is an increased risk of major and minor bleeding with no benefit on long-term functional outcomes. Conclusions: Patients with massive PE should receive thrombolytics when no major contraindications to therapy exist. Patients with submassive PE at highest risk for progression to hemodynamic instability should receive anticoagulation and be monitored for clinical deterioration. If an imminent risk of hemodynamic instability or cardiac arrest occurs, thrombolytics should be administered if no contraindications exist. Net mortality benefit and risk of bleeding must be considered when deciding to administer thrombolytic therapy in massive or submassive PE.


2017 ◽  
Vol 65 (6) ◽  
pp. 6S-7S ◽  
Author(s):  
Peter Lin ◽  
Elias Kfoury ◽  
Angela Echeverria ◽  
Stanley Duchman ◽  
Joseph Varon ◽  
...  

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