In 1978, 14 patients with massive or sub-massive pulmonary embolism (PE) were treated in the Intensive Care Unit of this hospital with a tissue culture Urokinase (TCUK). The total dose administered was 2,700,000 IU over 24 hours; Heparin was given concomitantly, at a dose controlled by coagulation tests. Diagnosis was established by angiography which was repeated 24 hours after treatment. Early resolution of the vascular obstructions was 40.6% - 21.2 of the total filling defect. Three recurrent PE were observed. In vivo fibrinolytic activity was confirmed the following parameters .- a fall in plasminogen level from 104.5% ± 1.4 to 51.4% ± 1.4, and increase in unheated fibrin plate lysis from 3.27 mm±0.4 to 33.42 mm ± 19 at 24 hours post treatment. Tolerance of TCUK was excellent and only two cases of mild bleeding were observed. One patient died the death was related neither to the TCUK treatment nor to the PE. when comparing the results from this group of patients with those obtained in a series of 97 patients treated over the last 4 gears with urinary Urokinase, no difference can be detected in the clinical efficacy or in the in vivo fibrinolytic activity of these two types of Urokinase. The authors conclude that tissue culture Uroxinase is a safe and effective treatment in the management of pulmonary embolism.
