Related Experiment Videos
Thrombolysis in pulmonary embolism: a debatable indication
1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston 02115, USA. sgoldhaber@partners.org
Thrombosis and Haemostasis
|August 7, 2001
Summary
Contemporary thrombolysis for pulmonary embolism (PE) safely reverses right heart failure, potentially lowering mortality. However, definitive survival trials are lacking, hindering widespread consensus on this debated treatment.
Area of Science:
- Cardiology
- Pulmonology
- Thrombolytic Therapy
Background:
- Pulmonary embolism (PE) thrombolysis offers rapid reversal of right heart failure.
- This approach may decrease PE-related mortality and chronic pulmonary hypertension morbidity.
Purpose of the Study:
- To evaluate the effectiveness and safety of contemporary thrombolysis for pulmonary embolism.
- To address the debate surrounding PE thrombolysis due to a lack of large survival-endpoint trials.
Main Methods:
- Review of existing thrombolysis trials for PE using surrogate endpoints.
- Analysis of current FDA-approved thrombolytic regimens and agents in development.
- Discussion of limitations in clinical trial design and funding for PE thrombolysis.
Main Results:
- Contemporary thrombolysis demonstrates rapid and safe reversal of right heart failure in PE.
- Current trials rely on surrogate endpoints (clot burden, pulmonary arterial pressure, RV function) rather than survival.
Conclusions:
- Pulmonary embolism thrombolysis is a potentially life-saving intervention but lacks definitive survival data.
- Future multicenter trials focusing on mortality and recurrent venous thromboembolism are crucial for establishing consensus.