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Repeated thrombolytic therapy after initial unsuccessful thrombolysis in massive pulmonary embolism
  1. R J M van den Biggelaar1,
  2. D-J Slebos1,
  3. J van der Meer2
  1. 1
    Department of Pulmonary Diseases, Thrombosis and Rheology, University Medical Centre Groningen, Groningen, The Netherlands
  2. 2
    Division of Haemostasis, Thrombosis and Rheology, University Medical Centre Groningen, Groningen, The Netherlands
  1. Dr D-J Slebos, Department of Pulmonary diseases, University Medical Centre Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands; d.j.slebos{at}int.umcg.nl

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In patients with massive pulmonary embolism threatened by haemodynamic instability, thrombolytic treatment is recommended.1 But when it fails, therapeutic options remain limited and are mainly guided by local expertise. In the current case, we report a potential treatment modality for this situation.

A 60-year-old male patient collapsed several times at home. He had a history of a curative left upper lobe lung resection 2 months previously because of a squamous cell lung carcinoma. On admission he suffered from severe dyspnoea. Physical examination showed an elevated central venous pressure and a systolic fixed splitting of the valve sounds. His systolic blood pressure was just below 80 mm Hg, with a pulse of 122 bpm. Thoracic CT angiography (angio-CT) confirmed suspected massive pulmonary embolism (fig …

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Footnotes

  • Competing interests: None.