Rapid Resolution of Pulmonary Thromboemboli in Man

Fred, Herbert L.

doi:10.1001/jama.1966.03100260075021

Cited by 79 publications

(6 citation statements)

References 4 publications

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“…Numerous case reports have indicated that, in man, substantial resolution of pulmonary embolism may occur spontaneously within days or weeks as demonstrated by pulmonary angiography (5,17). However, the early resolution rate of major pulmo-nary emboli is slow, as judged by angiography or lung scanning (1,4, 19) and significant resolution of major emboli does not seem to occur during the first week.…”

Section: Discussionmentioning

confidence: 99%

A Controlled Clinical Trial of Streptokinase and Heparin in the Treatment of Major Pulmonary Embolism

Arnesen

Eie

et al. 1978

Journal of Internal Medicine

187

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ABSTRACT. Treatment with streptokinase or heparin was allocated randomly to 20 patients with major pulmonary embolism verified by angiography. In addition, 4 patients treated with streptokinase and 1 patient treated with heparin were included in the trial prior to the start of treatment. Streptokinase or heparin was given for 72 hours and pulmonary angiography was repeated. The angiographic evidence of thrombolysis was significantly greater (p <0.01) in the 14 patients treated with streptokinase than in the 11 treated with heparin. In the heparin group, 1 patient died from massive embolism 15 hours after the start of treatment. In another patient who died 4 weeks later from cerebral glibolastoma, persistent massive embolism contributed to the fatal outcome. In the streptokinase group, 1 patient with a metastatic pulmonary carcinoma died 3 weeks after the start of treatment from gangrene of both legs following thrombotic occlusion of the inferior vena cava. Bleeding was more common after treatment with streptokinase than with heparin, but was not a serious problem in any patient. It is concluded that patients with life‐threatening pulmonary embolism should be offered the benefits of streptokinase.

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Section: Discussionmentioning

confidence: 99%

A Controlled Clinical Trial of Streptokinase and Heparin in the Treatment of Major Pulmonary Embolism

Arnesen

Eie

et al. 1978

Journal of Internal Medicine

187

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“…Die Emboli finden sich meistens in mehreren Lungenregionen (Tow et al 1967). Bevorzugte Lokalisation sind die Lungenunterlappen, und hier besonders rechts (FRED et al 1966;Tow et al 1967;MORRELL et al 1968). Die Untersuchung von LEDINGER (1980) ergibt:…”

Section: Pathomorphologieunclassified

“…In den angrenzenden Alveolen kann es zu einem kompensatorischen Emphysem 1977). Angiographische Untersuchungen zeigen jedoch, daß eine spontane Auflösung pulmonaler Thromboemboli innerhalb einer Woche möglich ist (FRED et al 1966). Bei anderen Patienten kann die schwere Obstruktion der Pulmonalgefäße aber auch für Wochen fortbestehen (DALEN et al 1969).…”

Section: Lungeninfarktunclassified

“…Embolus, kann bis zu 85% der verschlossenen Gefäße teilweise oder gänzlich funktionsfähig machen (MITTERMAYER 1977). Oft ist mit einer funktionell vollständigen Wiedereröffnung der verschlossenen Gefäßgebiete innerhalb von 4-6 Wochen zu rechnen (BRENNER 1935;FRED et al 1966). Dennoch bleiben bei etwa 10% der Patienten Perfusionsdefekte über die 6.…”

Section: Organisationunclassified

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Perfusionsstörungen

Mittermayer¹

1983

Spezielle Pathologische Anatomie

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Die morphologische Unterscheidung zwischen Thrombose und Thromboembolie ist oft schwer, mitunter unmöglich. So wird auch in der Literatur nicht immer exakt unterschieden zwischen dem in situ entstandenen Thrombus der Pulmonalarterien und dem embolisch in die Pulmonalarterien verschleppten Thrombus, was eine exakte Angabe der Häufigkeitsrelation beider Ereignisse erschwert. Generell läßt sich aber sagen, daß der Verschluß der Pulmonalarterien durch autochthone Thromben häufig vorkommt (KEATING et al. 1953), allerdings seltener als die Thromboembolie der Pulmonalarterien (BALL et al. 1956). Die Thrombose der Pulmonalarterien soll hier nur in soweit besprochen werden, als sie sich von der Thromboembolie, die im folgenden Kapitel ausführlich behandelt wird, unterscheidet. BALL et al. (1956) führen in ihrer Untersuchung über Thrombose und Thromboembolie der großen Pulmonalarterien folgende Unterscheidungskriterien an:1. Das Vorliegen lokaler Erkrankungen der Pulmonalarterien, beispielsweise von Atherosklerose, spricht für die in situ-Thrombose.2. Der autochthone Thrombus paßt im Gegensatz zu dem gewunden vorliegenden Embolus genau in das Gefäß.3. Der in si tu-Thrombus läßt eine schichtweise Ablagerung erkennen, wobei die einzelnen Lagen annähernd parallel zur Arterienwand verlaufen.

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“…Several reports have confirmed the rapid resolution of pulmonary embolism after commencing anticoagulant therapy (Tow and Wagner, 1967;Fred et al, 1966). However, there is much less information on the long-term outcome after an acute embolic episode (Editorial, 1978) and in some cases the interpretation of such studies has been limited by uncertainty concerning the criteria for initial diagnosis (Davies and Golshetti, 1973;Phear, 1960).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary embolism—a long-term follow-up

MacIntyre

Banham

Moran

1982

Postgraduate Medical Journal

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Summary Fifty-three patients without pre-existing cardiac or pulmonary disease were reviewed 5 to 9 years after angiographically proved pulmonary embolism. Ten of the 42 (24%) with an initial predisposing factor for embolism had died, including 6 from a previously diagnosed medical condition. In this group there was no significant residual disability among survivors and no late recurrence of embolism. By comparison, there were 6 deaths among the 11 in whom no predisposing factor was identified (55%), including 3 from neoplasm and 2 from recurrent embolism with cardiac failure. The identification of a predisposing factor at the time of embolism was associated with a significantly better long-term prognosis.

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Rapid Resolution of Pulmonary Thromboemboli in Man

Cited by 79 publications

References 4 publications

A Controlled Clinical Trial of Streptokinase and Heparin in the Treatment of Major Pulmonary Embolism

A Controlled Clinical Trial of Streptokinase and Heparin in the Treatment of Major Pulmonary Embolism

Perfusionsstörungen

Pulmonary embolism—a long-term follow-up

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