Currently, the only widely accepted indication for thrombolysis in cases of pulmonary embolism is hemodynamic instability. However, the presence of a right-heart thrombus along with pulmonary embolism is a poor prognostic indicator, and the use of thrombolytic agents should also be considered in this circumstance. Furthermore, despite a risk of distal embolization, thrombolytic therapy may be i...

The aim of this study was to evaluate the contribution of clinical, angiographic and haemodynamic findings in predicting the cardiorespiratory efficacy of thrombolytic therapy in acute massive pulmonary embolism. Haemodynamic measurements and pulmonary angiography were performed before (H0) and 12 h after (H12) initiating thrombolytic therapy in 23 patients with acute massive pulmonary embolism...

Between 1964 and 1986 a total of 71 pulmonary embolectomies were performed for acute massive pulmonary embolism. All patients were severely compromised haemodynamically. Sixteen (64%) of 25 patients who had sustained significant periods of cardiac arrest before operation died. The principal cause of death in this group was severe neurological damage. Five (11%) of the 46 who had not had a cardi...

The aim of this narrative review is to summarize for intensivists or any physicians managing "severe" pulmonary embolism (PE) the main recent advances or recommendations in the care of patients including risk stratification, diagnostic algorithm, hemodynamic management in the intensive care unit (ICU), recent data regarding the use of thrombolytic treatment and retrievable vena cava filters and...

a common complication of prosthetic heart valves is thrombosis. although the incidence of prosthetic valve thrombosis (pvt) in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided pvt. here, we describe three cases of tricuspid pvt with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants;...

CHEST I 103 I 5 1 MAY, 1993 1639 in terms of reduction of morbidity and/or mortality, the administration of heparin alone, followed by coumadin, should continue to be considered the standard of care and should be the therapy in the vast majority of cases of pulmonary embolism . Aside from perhaps use in patients dying ofthe obstructive effects ofthe acute embolism, the role of thrombolytic ther...

The natural course of acute pulmonary embolism depends primarily on whether the embolism has been detected and treated [1-4]. The haemodynamic severity of acute pulmonary embolism largely depends on the previous state of the cardiopuLmonary system in patients without any previous cardiopulmonary di ease [1, 5], the degree of haemodynamic severity (e.g. that of pulmonary hypertension) depends ex...