Document Detail

Should thrombolysis have a greater role in the management of pulmonary embolism?
MedLine Citation:
PMID:  19886101     Owner:  NLM     Status:  MEDLINE    
Pulmonary embolism (PE) continues to be associated with significant mortality despite advances in the diagnostic techniques available for its detection. Anticoagulation remains standard treatment in PE although there is a consensus view that 'step-up' to thrombolytic therapy in addition to anticoagulation is indicated in those patients who are systemically shocked at presentation--a group defined as having suffered 'massive pulmonary embolism'. Considerable research has been directed at attempting to identify further groups of patients with PE who are at high risk of morbidity and mortality--notably those who are labelled as having suffered 'sub-massive pulmonary embolism' where this is defined as the presence of right-heart strain in the absence of systemic shock. In particular, the potential benefit of extending thrombolytic therapy to include those patients with sub-massive PE has been the subject of much enquiry and debate. This review examines the evidence for thrombolytic therapy and explores the potential for risk stratification in PE.
Peter O Jenkins; Javed Sultanzadeh; Manasi Bhagwat; Paul F Jenkins
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical medicine (London, England)     Volume:  9     ISSN:  1470-2118     ISO Abbreviation:  Clin Med     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-04     Completed Date:  2009-12-01     Revised Date:  2010-05-04    
Medline Journal Info:
Nlm Unique ID:  101092853     Medline TA:  Clin Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-5     Citation Subset:  IM    
Worthing Hospital.
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MeSH Terms
Anticoagulants / therapeutic use*
Fibrinolytic Agents / therapeutic use*
Pulmonary Embolism / diagnosis*,  drug therapy*,  physiopathology
Risk Assessment
Thrombolytic Therapy*
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents
Comment In:
Clin Med. 2010 Apr;10(2):204-5; author reply 205   [PMID:  20438004 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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