[The thrombolytic therapy of pulmonary embolism]

Recent clinical trials demonstrate that thrombolytic therapy reduces morbidity and mortality of pulmonary embolism compared with heparin anticoagulation. Anticoagulant therapy fail to lyse thrombus that embolizes from the deep leg veins and from the pelvic veins. Anticoagulant therapy is useful in the prevention of recurrent embolism, event if the rate of recurrent embolism is lesser with thrombolytic therapy. Thrombolytic therapy can accelerate clot lysis and pulmonary reperfusion as well as reverse rapidly the associated right heart failure, which is the usual immediate cause of death. The benefit of thrombolytic therapy is easier to appreciate among patients with massive pulmonary embolism. Further trials are necessary to assess the efficacy and the safety of the different dosages of thrombolytic therapy in pulmonary embolism.