RT Journal Article
SR Electronic
T1 Understanding haemorrhagic risk following thrombolytic therapy in patients with intermediate-risk and high-risk pulmonary embolism: a hypothesis paper
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000735
DO 10.1136/openhrt-2017-000735
VO 5
IS 1
A1 Paul Abraham
A1 Diego A Arroyo
A1 Raphael Giraud
A1 Henri Bounameaux
A1 Karim Bendjelid
YR 2018
UL http://openheart.bmj.com/content/5/1/e000735.abstract
AB 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.