Chest
Volume 115, Issue 6, June 1999, Pages 1695-1707
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Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence

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Pulmonary embolism (PE) is a common disorder that is accompanied by significant morbidity and mortality. Although anticoagulation is the standard treatment for PE, thrombolytic therapy, with its ability to produce rapid clot lysis, has long been considered an attractive alternative. Although many studies have been performed over the past three decades, however, the indications for the use of thrombolytic agents in patients with PE remain controversial. In this article, we review the medical literature and provide evidence-based guidelines for the use of thrombolytic therapy. We will also discuss the practical aspects of PE thrombolysis.

Key words

fibrinolysis
pulmonary embolism
recombinant tissue-type plasminogen activator
streptokinase
thrombolytic therapy
urokinase

Abbreviations

ICH
intracranial hemorrhage
PAIMS2
Plasminogen Activator Italian Multicenter Study 2
PE
pulmonary embolism
PTT
partial thromboplastin time
rt-PA
recombinant tissue-type plasminogen activator
PIOPED
Prospective Investigation of Pulmonary Embolism Diagnosis
SK
streptokinase
UK
urokinase
UPET
Urokinase Pulmonary Embolism Trial
USET
Urokinase-Streptokinase Embolism Trial
/
ventilation-perfusion

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