RT Journal Article
SR Electronic
T1 Thrombolytic therapy for pulmonary embolism
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 411
OP 416
VO 43
IS 6
A1 Brian M. Katchan
YR 2000
UL http://canjsurg.ca/content/43/6/411.abstract
AB Consensus regarding the use of thrombolysis to treat acute pulmonary embolism has not yet been reached. There is good evidence that thrombolytic agents dissolve clot more rapidly than heparin. However, proving that this benefit reduces the death rate from pulmonary embolism has been difficult. Each of the 3 thrombolytic agents (tissue type-plasminogen activator, streptokinase and urokinase) is equally efficacious at dissolving clot, but all are associated with an increased risk of major hemorrhage when compared with heparin. One evolving position is that, in addition to patients presenting in circulatory collapse, for whom thrombolysis has been demonstrated to be life-saving, a subgroup of patients may be identified by echocardiography, through its ability to assess right ventricular dysfunction, who should also be considered for thrombolytic therapy. It remains to be seen whether this approach can reduce the death rate associated with pulmonary embolism.