[A successful lytic treatment of a perioperative pulmonary embolism necessitating resuscitation using recombinant...

We report a patient with massive perioperative pulmonary embolism (stage IV) and cardiac arrest who was successfully treated with recombinant tissue plasminogen activator (rt-PA). Thrombolytic therapy was started with 25 mg rt-Pa over 15 min followed by another 25 mg over 45 min. During the next 5 h 50 mg were infused, and thereafter an additional 50 mg over 24 h. No major alterations in the plasmatic coagulation profile were noted. With the exception of moderate blood loss from one puncture site, no further bleeding complications occurred. The relevance of this new thrombolytic agent in the perioperative management of acute, life-threatening pulmonary embolism is discussed.