This case demonstrates low-dose thrombolysis restoring reperfusion in high-risk pulmonary embolism patients on ECMO, indicating a potential rescue therapy.
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.
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Nehete et al. (2026) studied this question.
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