[Thrombolytic therapy for submassive/ intermediate risk Pulmonary Embolism Evidence and suggestions after PEITHO trial].
نویسندگان
چکیده
Therapy for submassive pulmonary embolism (intermediate risk), remains controversial. New evidence has appeared that may help us in the process of decision making. We review the relevant literature, outline prognostic factors, and discuss current recommendations and controversies regarding the available alternatives such as systemic and catheter-directed thrombolytic use.
منابع مشابه
Controversial and future role of thrombolysis and endovascular therapies in submassive pulmonary embolism.
We have read with interest the review article by Pulido et al. Early risk stratification is the cornerstone for success and effective therapy in acute pulmonary embolism (PE). Submassive (intermediate-risk) PE (20--25% of all PE events) represents a subgroup of patients with significant in-hospital mortality between 6 and 8%. Submassive PE has been defined as patients presenting with preserved ...
متن کاملSingle-bolus tenecteplase plus heparin compared with heparin alone for normotensive patients with acute pulmonary embolism who have evidence of right ventricular dysfunction and myocardial injury: Rationale and design of the Pulmonary Embolism Thrombolysis (PEITHO) trial
Background In acute pulmonary embolism (PE), overt right ventricular (RV) failure with cardiogenic shock indicates a poor prognosis. However, normotensive patients with acute RV dysfunction on echocardiography or computed tomography and with myocardial troponin elevation may also have an adverse outcome. Thrombolysis rapidly reverses RV pressure overload in PE, but it remains unclear whether it...
متن کاملAccelerated thrombolysis for pulmonary embolism: will clinical benefit be ULTIMAtely realized?
O ver the past 25 years, thrombolytic therapy has consistently demonstrated improvement in hemodynamic parameters in patients with pulmonary embolism (PE). 1 Clinically, although it results in reduced mortality in patients with massive PE, 2 thrombolytic therapy is not beneficial in unselected patients with PE. 3 Major societal guidelines support systemic throm-bolysis for massive PE and recomm...
متن کاملPotential role of systemic thrombolysis in acute submassive intermediate risk pulmonary embolism: review and future perspectives.
Submassive (intermediate risk) pulmonary embolism (PE) continues to be a significantly morbid disease process that remains unrecognized, inadequately risk stratified and suboptimally treated. Appropriate early clinical and imaging-based risk stratification represents the cornerstone for adequate therapeutic decision making, particularly for the selection of candidates who may benefit the most f...
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Massive pulmonary embolism (PE) is a highly lethal condition with clinical manifestations of hemodynamic instability, acute right ventricular (RV) failure, and cardiogenic shock. Submassive PE, as defined by RV failure or troponin elevation, can result in life-threatening sequelae if treatment is not initiated promptly. Current treatment paradigm in patients with massive PE mandates prompt risk...
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ورودعنوان ژورنال:
- Revista medica de Chile
دوره 143 7 شماره
صفحات -
تاریخ انتشار 2015