Related Experiment Videos
Thrombolytic therapy in pulmonary embolism
1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Seminars in Vascular Medicine
|June 17, 2004
Summary
Contemporary thrombolysis for pulmonary embolism (PE) safely reverses right heart failure. Further trials are needed to confirm reduced mortality and morbidity from PE, considering risks like intracranial hemorrhage.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Pharmacology
Background:
- Pulmonary embolism (PE) poses significant mortality risks, often leading to right heart failure.
- Thrombolysis is a potential treatment for PE, aiming to resolve clots and improve hemodynamics.
- Current evidence relies on surrogate endpoints rather than survival data, making PE thrombolysis a debated indication.
Purpose of the Study:
- To review the efficacy and safety of contemporary thrombolysis for pulmonary embolism.
- To discuss the limitations of current evidence and the need for future clinical trials.
- To highlight ongoing research into novel thrombolytic agents for PE treatment.
Main Methods:
- Review of existing literature on pulmonary embolism thrombolysis.
- Analysis of data from clinical trials and registries regarding thrombolytic therapy for PE.
- Discussion of approved and investigational thrombolytic agents and their dosages.
Main Results:
- Contemporary thrombolysis for PE demonstrates rapid and safe reversal of right heart failure.
- Established thrombolytic regimen involves recombinant tissue plasminogen activator (100 mg/2 h).
- Intracranial hemorrhage risk in PE thrombolysis ranges from 1.7% to 3.0%.
Conclusions:
- Thrombolysis for PE may reduce mortality and chronic pulmonary hypertension morbidity.
- Future trials must focus on mortality and recurrent venous thromboembolism, with careful risk-benefit assessment.
- Development of new agents like reteplase, saruplase, and recombinant staphylokinase is underway.