Related Experiment Video
Updated: Jun 25, 2026
07:50
An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
Published on: June 4, 2021
Thrombolytic therapy for venous thromboembolism: current clinical practice
Gregg J Stashenko1, Charles W Hargett, Victor F Tapson
1Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Journal of Hospital Medicine
|March 7, 2009
Summary
Pulmonologists frequently consider thrombolytic therapy for venous thromboembolism (VTE), especially for massive pulmonary embolism (PE). Despite evolving guidelines, practice patterns remain consistent, highlighting the need for further research and education on VTE treatment.
Area of Science:
- Pulmonary Medicine
- Cardiovascular Medicine
- Critical Care
Background:
- Venous thromboembolism (VTE) is a serious condition where thrombolytic therapy may offer benefits.
- The optimal use of thrombolytic therapy for VTE is debated.
- Previous studies documented practice patterns; this study re-evaluates current use and physician beliefs.
Purpose of the Study:
- To re-evaluate the use of thrombolytic therapy in venous thromboembolism (VTE).
- To assess current practice patterns and physician beliefs regarding thrombolytic therapy for VTE.
- To compare current practices with previous findings in light of updated guidelines.
Main Methods:
- A web-based questionnaire was distributed to active pulmonologists in 11 southeastern states.
- The survey included questions on physician background and hypothetical VTE case scenarios.
- Respondents indicated their likelihood of using thrombolytic therapy in various clinical situations.
Main Results:
- 84% of surveyed pulmonologists reported using thrombolytic therapy for VTE in the past two years.
- 99% would consider thrombolytics for massive pulmonary embolism (PE) with hypotension.
- A majority would consider thrombolytics for PE with severe hypoxemia (83%) or right ventricular dysfunction (62%).
Conclusions:
- Most pulmonologists would consider thrombolytic therapy for massive PE, even with contraindications.
- Physician practices align with previous surveys, indicating limited change despite evolving data.
- Further physician education and randomized trials are necessary to clarify optimal VTE management with thrombolytics.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:27Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...