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Systemic Thrombolysis for Pulmonary Embolism: Who and How by Victor F. Tapson; Oren Friedman is a Medicine article available to read on EtoBox.

What is Systemic Thrombolysis for Pulmonary Embolism: Who and How about?

Anticoagulation has been shown to improve mortality in acute pulmonary embolism (PE). Initiation of anticoagulation should be considered when PE is strongly suspected and the bleeding risk is perceived to be low, even if acute PE has not yet been proven. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher when systemic thrombolytic therapy is administered. It has been demonstrated that right ventricular dysfunction, as well as abnormal biomarkers (troponin and brain natriuretic peptide) are associated with increased mortality in acute PE. In spite of this, intermediate-risk (submassive) PE comprises a fairly broad clinical spectrum. For several decades, clinicians and clinical trialists have worked toward a more aggressive, yet safe solution for patients with intermediate-risk PE. Standard-

Who reads Systemic Thrombolysis for Pulmonary Embolism: Who and How?

Author

Victor F. Tapson; Oren Friedman

Publisher

Elsevier Science; Elsevier ; W. B. Saunders Co., Ltd.; Elsevier BV (ISSN 1089-2516)

Published

2017

Language

EN

Field

Medicine (Health Sciences)