The role of thrombolytic therapy in the treatment of acute sub massive pulmonary embolism: A single center observational study from India

摘要

Background: Routine use of thrombolytic therapy in hemodynamicallystable patients with sub massive pulmonary embolismis controversial.Rationale: To observe the safety & efficacy of thrombolytic therapyin acute pulmonary embolism patients with normal bloodpressure and right ventricular dysfunction.Methods: In this study, 130 patients with sub-massive pulmonaryembolism who had right ventricular (RV) dysfunction, wereincluded and treated with thrombolytic therapy.Results: Mean age of our study patients was 43 +/- 14. 9 years.Fifty-three (41%) patients in our study were within forty years ofage. Hundredeeight (83%) patients had clinical improvement inNYHA class and it was statistically significant (p<0.001). Both RVdysfunction and pulmonary artery systolic pressure (PASP)improved significantly following thrombolytic therapy frombaseline (mean PASP 49mmof Hg vs 28mmof Hg; p?0.01; 95% CI?-13 to e 56). Twelve (9%) patients died and two patients (1.5%)developed intra cerebral haemorrhage.Conclusion: Thrombolytic therapy is helpful in improving clinicalcourse following sub-massive acute pulmonary embolism.