Acute pulmonary embolism treated with tissue plasminogen activator

Area of Science:

• Cardiology
• Pulmonary Medicine
• Thrombolytic Therapy

Background:

• Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
• Effective thrombolytic strategies for PE are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of peripheral intravenous recombinant human tissue-type plasminogen activator (rt-PA) in patients with acute pulmonary embolism.

Main Methods:

• 36 patients with angiographically confirmed PE received rt-PA (50 mg/2 h, followed by 40 mg/4 h if needed).
• Angiography was performed at baseline and 6 hours to assess clot lysis.
• Quantitative scoring and fibrinogen levels were monitored.

Main Results:

• 34 of 36 patients demonstrated angiographic evidence of clot lysis within 6 hours.
• Significant improvement in quantitative lysis scores (21% at 2h, 49% at 6h).
• Fibrinogen levels decreased by 30% at 2h and 38% at 6h.

Conclusions:

• Peripheral intravenous rt-PA is effective in achieving thrombolysis for pulmonary embolism.
• While generally safe, two patients experienced major complications, highlighting the need for careful patient selection.
• These findings support expanded investigational use of this rt-PA administration route for PE.