Systemic intravenous thrombolysis decreases mortality in high-risk pulmonary embolism but increases haemorrhagic risk, highlighting the need for tailored drug administration and patient selection.
While systemic intravenous thrombolysis decreases mortality in patients with high-risk pulmonary embolism (PE), it clearly increases haemorrhagic risk. There are many contraindications to thrombolysis, and efforts should aim at selecting those patients who will benefit most, without suffering complications. The current review summarises the evidence for the use of thrombolytic therapy in PE. It clarifies the pathophysiological mechanisms in PE and acute cor pulmonale that increase the risk of bleeding following thrombolysis. It discusses future management challenges, namely tailored drug administration, new treatment monitoring techniques and catheter-directed thrombolysis.
Abraham et al. (Thu,) conducted a review in Intermediate-risk and high-risk pulmonary embolism. Thrombolytic therapy was evaluated. Systemic intravenous thrombolysis decreases mortality in high-risk pulmonary embolism but increases haemorrhagic risk, highlighting the need for tailored drug administration and patient selection.
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