TY - JOUR 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 DO - 10.1136/openhrt-2017-000735 VL - 5 IS - 1 SP - e000735 AU - Paul Abraham AU - Diego A Arroyo AU - Raphael Giraud AU - Henri Bounameaux AU - Karim Bendjelid Y1 - 2018/02/01 UR - http://openheart.bmj.com/content/5/1/e000735.abstract N2 - 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. ER -