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Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary 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...
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Venous 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...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary 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...
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Embolism I: Introduction01:19

Pulmonary Embolism I: Introduction

A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...

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Updated: Jun 21, 2026

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
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An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug

Published on: June 4, 2021

Thrombolytic therapy for pulmonary embolism.

Bi Rong Dong1, Qiukui Hao, Jirong Yue

  • 1Department of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China, 610041.

The Cochrane Database of Systematic Reviews
|July 10, 2009
PubMed
Summary

Thrombolytic therapy for pulmonary embolism (PE) shows similar death and recurrence rates compared to heparin alone, but with increased bleeding risks. Further research is needed to clarify its effectiveness, especially in different patient groups.

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Pharmacology

Background:

  • Thrombolytic therapy is typically reserved for severe pulmonary embolism (PE).
  • While potentially faster at dissolving clots than heparin, concerns exist regarding increased hemorrhage risks.
  • This review updates previous findings on thrombolytic therapy for PE.

Purpose of the Study:

  • To evaluate the effectiveness and safety of thrombolytic therapy in patients diagnosed with acute PE.
  • To compare thrombolytic therapy against placebo, heparin, or surgical interventions.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched Cochrane Library, specialized registers, and relevant databases up to April 2009.
  • Included eight RCTs involving 679 patients, comparing thrombolytics with heparin or placebo.

Main Results:

  • Thrombolytics showed similar rates of death (OR 0.89) and PE recurrence (OR 0.63) compared to heparin.
  • A higher risk of major (OR 1.61) and minor (OR 1.98) hemorrhages was observed with thrombolytics.
  • Combination therapy with recombinant tissue-type plasminogen activator (rt-PA) and heparin reduced in-hospital events (OR 0.35).
  • Thrombolytics demonstrated superior improvements in hemodynamic and imaging outcomes compared to heparin alone.

Conclusions:

  • Current limited evidence does not definitively establish thrombolytic therapy's superiority over heparin for PE.
  • Further high-quality, double-blind RCTs are needed, particularly with subgroup analyses for hemodynamically stable versus unstable PE patients.