[Course of pulmonary embolism]

Area of Science:

• Cardiology
• Vascular Medicine
• Pulmonology

Background:

• Pulmonary embolism (P.E.) and associated venous thrombosis (V.T.) pose significant health risks.
• Proximal V.T. linked to P.E. contributes to severe complications.

Purpose of the Study:

• To evaluate the effectiveness of various treatments for P.E. and associated V.T.
• To assess the impact of treatments on mortality, recurrence, and long-term sequelae.

Main Methods:

• 155 patients with recent P.E. underwent angiopneumography and phlebocavography.
• Treatments included heparin, streptokinase (SK), urokinase (UK), and inferior vena cava interruption (I.V.C.I.).
• Patients were assessed for P.E. resolution, V.T. changes, mortality, recurrence, and post-phlebitis syndrome.

Main Results:

• Streptokinase (SK) showed more rapid P.E. clot resolution than urokinase (UK) and was the only effective treatment for iliac/vena cava thromboses.
• Therapeutic failure rate was lowest with SK (19%).
• High mortality (14%) was associated with massive P.E.; recurrences were fatal in 60% of cases.

Conclusions:

• Pulmonary thrombo-embolic disease is severe, with early deaths from recurrences and late incapacitation from post-phlebitis syndrome.
• Proximal V.T. associated with P.E. necessitates routine phlebocavography and aggressive treatment.
• Streptokinase (SK) or inferior vena cava interruption (I.V.C.I.) are recommended for iliocaval disease.