The results at 6 months of slow thrombolysis in pulmonary thromboembolism

Abstract Title: The results at six month of slow thrombolysis in pulmonary thromboembolism
Authors: Doina Rosu, L. Vasiluta
Affiliation: University of Medicine and Pharmacy “Victor Babes” Timisoara, Cardiology Dept., County Emergency Hospital Timisoara, Romania
Abstract text: Objectives: The patients were diagnosed with cute pulmonary thromboembolism (PTE) and altered hemodynamic status or cardiogenic shock, were thrombolysed with streptokinases according with actually new guidelines. Material and methods: 33 patients, 12 male and 21 female and medium age 60 ± 14 on several etiology (without neoplasia) in which appeared clinical criteria for thromboembolism during 10 days ago, were confirmed in diagnosis by pulmonary arteries angio-CT with contrast substance. They had more than 40% obstruction on total arterial vessel. Thrombolysis was performed with streptokinase 250 000 i.v. initial bolus followed by 100000 u/ 24 hours. After 24 h was introduced classical anticoagulant i.v. treatment with heparin (1000 u/1h) under controlled TPA, and later 6 month oral anticoagulation. The efficiency of thrombolysis (unfortunately without distinct criteria for reperfusion) was estimated on clinical status, and monitorization of ECG and Echocardiographic parameters during 6 month. Pulmonary angio-CT was repeated at 6 month later. Results: after 6month, in 26 patients (81%) were obviously an improvement of clinical status, without significant pulmonary hypertension. In 4 patients we did not obtain improvement of clinical status and they developed pulmonary hypertension, while pulmonary angio-CT results were worse. 2 patients developed hemorrhagic events and 1 patient died. Conclusion: Patients with PTE with debut under 10 days had an evident benefit of slow thrombolysis with streptokinase, followed by anticoagulant treatment at 6 months, without significant risk events in connection with this treatment.
Keywords: acute pulmonary thromboembolism, thrombolysis
Presentation type: Oral
Correspondence: Timisoara,Bd I Bulbuca no. 169, Spitalul Clinic Judetean de Urgenta, Clinica de Cardiologie
Email: dr_doinarosu@yahoo.com