What question did this study set out to answer?

To evaluate the effectiveness and safety of low-dose systemic alteplase during ECMO in high-risk pulmonary embolism cases.

March 16, 2026Open Access

Low-Dose Systemic Thrombolysis as Rescue Therapy After Catheter-Directed Thrombectomy for High-Risk Pulmonary Embolism on VA-ECMO

Key Points

To evaluate the effectiveness and safety of low-dose systemic alteplase during ECMO in high-risk pulmonary embolism cases.
Administered low-dose systemic alteplase on venoarterial ECMO
Monitored patient for resolution of shock and right ventricular function
Reviewed contraindications and outcomes of catheter-directed thrombectomy (CDT)
Successful restoration of reperfusion observed after thrombolysis
Resolution of shock noted in the patient
Improvement in right ventricular unloading and function

Abstract

In high-risk PE with shock and contraindications or failure of CDT, systemic thrombolysis remains the first-line reperfusion therapy. This case demonstrates that low-dose systemic alteplase can be safely administered on venoarterial extracorporeal membrane oxygenation to restore reperfusion and unload the failing right ventricular, leading to resolution of shock.

Low-Dose Systemic Thrombolysis as Rescue Therapy After Catheter-Directed Thrombectomy for High-Risk Pulmonary Embolism on VA-ECMO

Key Points

Abstract

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