ACUTE PULMONARY EMBOLISM TREATED WITH TISSUE PLASMINOGEN ACTIVATOR

Samuel Z. Goldhaber*, John E. Markis, Michael F. Meyerovitz, Duck Soo Kim, Douglas L. Dawley, Arthur Sasahara, Douglas E. Vaughan, Andrew P. Selwyn, Joseph Loscalzo, Craig M. Kessler, G. V R K Sharma, Elliott B. Grossbard, Eugene Braunwald

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

149 Scopus citations

Abstract

Recombinant human tissue-type plasminogen activator (rt-PA) was given via a peripheral vein to 36 patients with angiographically documented pulmonary embolism. The regimen was 50 mg/2 h followed by repeat angiography and, if necessary, an additional 40 mg/4 h. By 6 h, 34 of 36 patients had angiographic evidence of clot lysis, slight in 4, moderate in 6, and marked in 24. The quantitative score improved 21% by 2 h and 49% by 6 h. Fibrinogen decreased 30% from baseline at 2 h and 38% from baseline at 6 h. 2 patients had major complications: in one, bleeding from a pelvic tumour required surgery, in the other, who had had coronary artery bypass surgery eight days earlier, pericardial tamponade developed. These initial results in selected patients make a case for expanded investigational use of peripheral intravenous rt-PA in pulmonary embolism.

Original languageEnglish (US)
Pages (from-to)886-889
Number of pages4
JournalThe Lancet
Volume328
Issue number8512
DOIs
StatePublished - Oct 18 1986

ASJC Scopus subject areas

  • Medicine(all)

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