Use of thrombolytic agents in the treatment of acute pulmonary thromboembolism: things are not as simple as you might think

Miranda, Carlos; Fernandes, Constantino José; Jardim, Carlos; Alves, José Leonidas; Oleas, Francisca Alexandra Gavilanes; Morinaga, Luciana Tamie Kato; Souza, Rogério

doi:10.1590/1806-3713/e20180297

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…Использование ТЛТ у явно стабильных больных с субмассивной ТЭЛА или ТЭЛА промежуточного риска не рекомендуется до наступления гемодинамической декомпенсации или коллапса, развивающихся во время терапии НФГ [46]. Необходимо проведение дополнительных исследований для улучшения научного понимания в отношении применения тромболитической терапии у гемодинамически стабильных больных [47].…”

Section: показания для тлт при тэлаunclassified

Present aspects of thrombolytic therapy of pulmonary artery thromboembolism

Ovchinnikov

Zelenov²,

Половинка

et al. 2021

jour

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The concept of high-risk pulmonary artery embolism determines that verification of the occlusion of the pulmonary arterial bed requires urgent restoration of pulmonary blood flow in such patients. Thrombolytic therapy is currently recognized as the main treatment for pulmonary artery thromboembolism. It can save patients’ lives, prevent the development of chronic post embolic pulmonary hypertension and thromboembolism recurrence. The literature review presents thrombolytic medications used in the treatment of pulmonary thromboembolism, describes indications for thrombolytic therapy, comparative efficiency and safety of various thrombolytics. The main complications of thrombolytic therapy are described and the issues of increasing its safety are raised. Criteria for the success of thrombolysis are early diagnosis, accurate risk stratification, and adequate use of reperfusion agents in patients with high-risk or transitionally high-risk of pulmonary embolism.

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Section: показания для тлт при тэлаunclassified

Present aspects of thrombolytic therapy of pulmonary artery thromboembolism

Ovchinnikov

Zelenov²,

Половинка

et al. 2021

jour

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Severe pulmonary tuberculosis complicated with insidious pulmonary thromboembolism: a case report and literature review

Huang

Yin

et al. 2019

J Thromb Thrombolysis

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Pulmonary thromboembolism (PTE) is an acute and severe disease with high mortality, which is prone to be misdiagnosed or ignored especially when complicated with tuberculosis (TB). Even though TB has been considered as a risk factor for PTE, there is rare report of TB with PTE worldwide. Which TB patients are more susceptible to PTE is still not clear. Here, we described a case report of PTE with pulmonary TB in a 28-year-old man, who had no risk factors for pulmonary thrombosis at admission and developed a medium-high PTE after initiating anti-TB therapy. After local thrombolysis with interventional therapy and sequential intravenous thrombolysis, combined with long-term anticoagulation, the PTE of the patient disappeared. At follow-up of 4 months, the patient was reexamined with chest enhanced CT and no obvious emboli was found. We emphasize that acute or severe TB infection should be included in the thromboembolism risk assessment and prophylactic use of anticoagulants may be considered even if there are no other obvious risk factors. Interventional therapy is a good option for thrombolysis treatment if hospital condition permits.

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Pulmonary Embolism and Gas Exchange

et al. 2019

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Acute pulmonary embolism (PE) impairs hemodynamics, gas exchange, and lung mechanical capacity. Considering PE pathophysiology, most attention has been paid to hemodynamic impairment. However, the most prevalent symptoms in PE patients come from gas exchange alterations, which have not been in the spotlight for many years. Pulmonary physiology and consequent gas exchange impairment play a pivotal role in the high risk of death from PE. In this review, we will look at the pathophysiology of PE, from the vascular occlusion to the resultant heterogeneity in pulmonary perfusion and gas exchange impairment, discussing in detail its causes and consequences.

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Use of thrombolytic agents in the treatment of acute pulmonary thromboembolism: things are not as simple as you might think

Cited by 7 publications

References 11 publications

Present aspects of thrombolytic therapy of pulmonary artery thromboembolism

Present aspects of thrombolytic therapy of pulmonary artery thromboembolism

Severe pulmonary tuberculosis complicated with insidious pulmonary thromboembolism: a case report and literature review

Pulmonary Embolism and Gas Exchange

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