Thrombolytic therapy in acute pulmonary embolism.


Journal Article (Review)

PURPOSE OF REVIEW: The goal of this review is to offer an overview of the use of thrombolytic therapy in acute pulmonary embolism. Clinicians including internists, surgeons, pulmonologists, and other specialists continue to face decisions regarding massive and submassive acute pulmonary embolism in their daily routines. Although an evidence base exists, unanswered questions remain regarding the use of thrombolytic agents. RECENT FINDINGS: Few large, randomized trials exist in this area of medicine and unanswered questions remain. However, guidelines have been modified and new guidelines have been published over the past several years. Recent data indicating that lower doses of tissue plasminogen activator may be effective and safer are discussed. Newer thrombolytic agents may have advantages, but are less well studied. SUMMARY: Thrombolytic therapy results in the accelerated lysis of acute pulmonary embolism. However, because nonpathologic thrombi are also lysed, these drugs, although potentially lifesaving, can cause significant bleeding complications. Massive acute pulmonary embolism is the clearest indication for the administration of thrombolytic agents, but patients with acute pulmonary embolism and significant compromise in the absence of hypotension may also merit consideration.

Full Text

Cited Authors

  • Tapson, VF

Published Date

  • November 2012

Published In

Volume / Issue

  • 27 / 6

Start / End Page

  • 585 - 591

PubMed ID

  • 23075820

Pubmed Central ID

  • 23075820

Electronic International Standard Serial Number (EISSN)

  • 1531-7080

International Standard Serial Number (ISSN)

  • 0268-4705

Digital Object Identifier (DOI)

  • 10.1097/hco.0b013e328358308c


  • eng