Thrombolytic Treatment with Recombinant Tissue-Type Plasminogen Activator in a Patient with Massive Pulmonary Embolism

Brief Reports1 July 1985Thrombolytic Treatment with Recombinant Tissue-Type Plasminogen Activator in a Patient with Massive Pulmonary EmbolismHENRI BOUNAMEAUX, M.D., JOSEPH VERMYLEN, M.D., COLLEN DÉSIRÉ, M.D.; Ph.D.HENRI BOUNAMEAUX, M.D., JOSEPH VERMYLEN, M.D., COLLEN DÉSIRÉ, M.D.; Ph.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-1-64 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPhysiologic thrombolysis appears to be regulated via adsorption of tissue-type plasminogen activator and plasminogen on the fibrin surface, and generation of plasmin out of reach of circulating alpha2-antiplasmin (1). The thrombolytic agents streptokinase and urokinase, which have no specific affinity for fibrin, activate circulating and fibrin-bound plasminogen without preference. Extensive plasminogen activation and plasmin generation will exhaust alpha2-antiplasmin, and then free circulating plasmin will degrade several plasma coagulation proteins such as fibrinogen, factor V, and factor VIII. This hemostatic breakdown may cause bleeding. Therefore, fibrinspecific plasminogen activators could constitute safer thrombolytic agents. Promising results have been reported in...References1. COLLEN D. On the regulation and control of fibrinolysis. Thromb Haemost. 1980;43:77-89. CrossrefMedlineGoogle Scholar2. MATSUORIJKENCOLLEN ODD. Comparison of the relative fibrinogenolytic, fibrinolytic and thrombolytic properties of tissue plasminogen activator and urokinase in vitro. Thromb Haemost. 1981;45:225-9. CrossrefMedlineGoogle Scholar3. MATSUORIJKENCOLLEN ODD. Thrombolysis by human tissue plasminogen activator and urokinase in rabbits with experimental pulmonary embolus. Nature. 1981;291:590-1. CrossrefMedlineGoogle Scholar4. KORNINGERMATSUOSUYSTASSENCOLLEN CORJD. Thrombolysis with human extrinsic (tissue-type) plasminogen activator in dogs with femoral vein thrombosis. J Clin Invest. 1982;69:573-80. CrossrefMedlineGoogle Scholar5. WEIMARSTIBBEVAN SEYENBILLIAUDE SOMERCOLLEN WJAAPD. Specific lysis of an iliofemoral thrombus by administration of extrinsic (tissue-type) plasminogen activator. Lancet. 1981;2:1018-20. CrossrefMedlineGoogle Scholar6. VAN DE WERFLUDBROOKBERGMANN FPS. Coronary thrombolysis with tissue-type plasminogen activator in patients with evolving myocardial infarction. N Engl J Med. 1984;310:609-13. CrossrefMedlineGoogle Scholar7. COLLENTOPOLTIEFENBRUNN DEA. Coronary thrombolysis with recombinant human tissue-type plasminogen activator: a prospective, randomized, placebo-controlled trial. Circulation. 1984;70:1012-7. CrossrefMedlineGoogle Scholar8. COLLENVERSTRAETE DM. Alpha-2 antiplasmin consumption and fibrinogen breakdown during thrombolytic therapy. Thromb Res. 1979;14:631-9. 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Author, Article, and Disclosure InformationAuthors: HENRI BOUNAMEAUX, M.D.; JOSEPH VERMYLEN, M.D.; COLLEN DÉSIRÉ, M.D.; Ph.D.Affiliations: University of Leuven Leuven Belgium PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAlteplase for the Treatment of Pulmonary EmbolismPharmacokinetics and Pharmacodynamics of Fibrinolytic AgentsPulmonary Embolism: What Have We Learned Since Virchow?Pulmonary embolism—an update on thrombolytic therapyAcute Massive Pulmonary Embolism Following High Ligation Combined with Compression Sclerotherapy for Varicose VeinsCase of Biatrial ThrombosisPulmonary embolism--the role of thrombolytic therapy in its management.Thrombolytic therapy in patients with acute pulmonary embolismTreatment of massive pulmonary embolism with centrally administered tissue-type plasminogen activatorEffects of intravenous urokinase versus alteplase on total pulmonary resistance in acute massive pulmonary embolism: A European multicenter double-blind trialAcquired Lesions of Major Blood VesselsThrombolysis for pulmonary embolismTissue plasminogen activator for the treatment of thromboembolism in infants and childrenTissue-plasminogen activator for pulmonary embolism resulting in shock: two case reports and discussion of the literatureTissue-plasminogen activator for pulmonary embolism resulting in shock: two case reports and discussion of the literatureStreptokinase therapy for deep vein thrombosis: A comprehensive review of the english literatureTissue Plasminogen Activator for the Treatment of Acute Pulmonary EmbolismRapid lysis of life-threatening pulmonary thromboembolism following recent abdominal surgery using a modified systemic infusion of rt-paRapid Resolution of Acute Cor Pulmonale with Recombinant Tissue Plasminogen ActivatorTissue plasminogen activator therapy of glomerular thrombi in the Shwartzman reactionAcute pulmonary embolism treated with thrombolytic agents: Current status of tPA and future implications for emergency medicineTissue Plasminogen ActivatorAcute Pulmonary Thromboembolism Treated Successfully by Balloon Angioplasty—A Case ReportTreatment of canine embolic pulmonary hypertension with recombinant tissue plasminogen activator. Efficacy of dosing regimes.Pulmonary EmbolismRAPID RESOLUTION OF SUBCLAVIAN VEIN THROMBOSIS BY TISSUE PLASMINOGEN ACTIVATORPulmonary embolismDeep Venous Thrombosis and Pulmonary Embolism in Trauma PatientsHeart Failure in Acute Pulmonary HypertensionEarly reversal of right ventricular dysfunction in patients with acute pulmonary embolism after treatment with intravenous tissue plasminogen activatorThrombolytic therapy of acute pulmonary embolism: Current status and future potentialManagement of arterial emboliLysis of Venous, Pulmonary, Prosthetic Valvular, Arterial, and Ventricular ClotsPlasminogen Activators and their Potential in TherapyMassive Pulmonary Embolism: Short-Term Effects of Thrombolytic TreatmentACUTE PULMONARY EMBOLISM TREATED WITH TISSUE PLASMINOGEN ACTIVATORTreatment of venous thromboembolic diseasePulmonary embolismThe fibrinolytic system in man 1 July 1985Volume 103, Issue 1Page: 64-65KeywordsBlood plasmaFibrinFibrinogenHemorrhageHemostaticsPlasma proteinsPlasminsPulmonary embolismThrombosis ePublished: 1 December 2008 Issue Published: 1 July 1985 PDF downloadLoading ...