PURPOSE: Evaluate efficacy and safety of short-term thrombolysis with recombinant human-tissue plasminogen activator (rtPA). METHODS: Thrombolysis with rtPA was performed in 29 patients with angiographically documented severe acute pulmonary embolism (Miller score of 20/34 or more). All patients received 100 mg rtPA through peripheral veins within the first 2 hr, followed by a continuous infusion of rtPA (0.05 mg/kg/hr) over a 4-hr period. Concomitant intravenous heparin 1000 U/hr infusion was applicated for the first 6 hr. RESULTS: Using this treatment, 83% of our patients showed clinical improvement objectified by the Miller score, by the clinical stage (Grosser), and by the pulmonary artery mean pressure (PAPm). The treatment regimen was unsuccessful if the clinical history lasted more than 3 days. Complications occurred in 10 patients (34%), and 3 patients (10%) died of acute right heart failure. CONCLUSION: The success of rtPA treatment appears to depend on the interval between onset of symptoms and start of thrombolytic therapy. Otherwise the technique leads to objectifiable improvement within 6 hr with an acceptable bleeding risk.
PURPOSE: Evaluate efficacy and safety of short-term thrombolysis with recombinant human-tissue plasminogen activator (rtPA). METHODS: Thrombolysis with rtPA was performed in 29 patients with angiographically documented severe acute pulmonary embolism (Miller score of 20/34 or more). All patients received 100 mg rtPA through peripheral veins within the first 2 hr, followed by a continuous infusion of rtPA (0.05 mg/kg/hr) over a 4-hr period. Concomitant intravenous heparin 1000 U/hr infusion was applicated for the first 6 hr. RESULTS: Using this treatment, 83% of our patients showed clinical improvement objectified by the Miller score, by the clinical stage (Grosser), and by the pulmonary artery mean pressure (PAPm). The treatment regimen was unsuccessful if the clinical history lasted more than 3 days. Complications occurred in 10 patients (34%), and 3 patients (10%) died of acute right heart failure. CONCLUSION: The success of rtPA treatment appears to depend on the interval between onset of symptoms and start of thrombolytic therapy. Otherwise the technique leads to objectifiable improvement within 6 hr with an acceptable bleeding risk.
Authors: M Verstraete; G A Miller; H Bounameaux; B Charbonnier; J P Colle; G Lecorf; G A Marbet; P Mombaerts; C G Olsson Journal: Circulation Date: 1988-02 Impact factor: 29.690
Authors: P A Randall; E R Heitzman; M J Bull; E M Scalzetti; S K Williams; L P Gordon; B Markarian Journal: Radiographics Date: 1989-09 Impact factor: 5.333
Authors: S Z Goldhaber; C M Kessler; J Heit; J Markis; G V Sharma; D Dawley; J S Nagel; M Meyerovitz; D Kim; D E Vaughan Journal: Lancet Date: 1988-08-06 Impact factor: 79.321