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Cited by 21Venous Thromboembolism Diagnosis and ManagementAcute Myocardial Infarction ResearchAcute Ischemic Stroke Management

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.

Systemic or local thrombolysis in high-risk pulmonary embolism

Open access
Macovei, Liviu, Presura, Razvan Mihai, Arsenescu Georgescu, Catalina·2015·Cardiology Journal

Abstract

BACKGROUND AND AIM: High-risk pulmonary embolism (PE) represents an important health problem in emergency cardiology, being associated with a high rate of mortality. The aim of this study is to assess the efficacy and safety of pulmonary intra-arterial thrombolysis with streptokinase compared to systemic thrombolysis. METHODS AND RESULTS: In our study, 28 patients with acute high risk PE were treated by intra-arterial thrombolysis with clinical success rate of 96.4%, while in the group with systemic thrombolysis (24 patients) the rate of clinical success was significantly lower (70.8%). Also, pressure gradient between right ventricle (RV) and right atrial (RA) (PRV-RA) decreased significantly in patients treated by pulmonary intra-arterial thrombolysis instead of systemic thrombolysis. Mortality during the hospitalization was 0% in the group with local thrombolysis and 29.2% in the other group, with a significant statistical difference. Major bleeding complications appeared in 14.3% of the patients with local thrombolysis and in 20.8% of the ones treated by systemic thrombolysis, without statistical significance. Moreover, the proportion of minor bleeding was comparable in the two groups of patients. There was no intracranial bleeding. Disseminated intravascular coagulation occurred in 1 patient with systemic thrombolysis. CONCLUSIONS: The rate of clinical success and the regression of RV overload were significantly higher in patients treated by pulmonary intra-arterial thrombolysis. The results regarding the efficiency of the pulmonary intra-arterial thrombolysis in high-risk PE are encouraging, the mortality in these patients being significantly lower than the one for systemic administration of the thrombolytic agent.

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Research works printed but not linked: 3

  1. Kucher N. Catheter interventions in massive pulmonary embo- lism. Cardiol Rounds, 2006; 10: 3.
  2. Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Massive pulmo- nary embolism. Circulation, 2006; 113: 577-582.
  3. Urokinase-Streptokinase Embolism Trial: Phase 2. JAMA, 1974; 229: 1606-1613.

Cited by

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Metadata

Authors
Macovei, L., Presura, R. M., & Arsenescu Georgescu, C.
Affiliations
Grigore T. Popa University of Medicine and Pharmacy (RO)
Venue
Cardiology Journal
Published
2015-08-28
Volume
22
Issue
4
Pages
467-474
ISSN
  • 1897-5593 (ISSN-L)
  • 1898-018X
OpenAlex
W2100824078
Cited by
17
References
19
Citations by year
2025: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 4 · 2018: 2 · 2017: 2 · 2015: 1
FWCI
1.70
Type
journal article
Language
en
Open access
Locations
  • Cardiology Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Keywords
massive pulmonary embolism, intra-arterial thrombolysis, intravenous thrombolysis, streptokinase, right ventricular pressure gradient, right ventricular overload, bleeding complications, mortality, disseminated intravascular coagulation, intracranial hemorrhage
MeSH terms
Adult, Aged, Echocardiography, Electrocardiography, Female, Fibrinolytic Agents, Hemodynamics, Hemorrhage, Humans, Infusions, Intra-Arterial, Infusions, Intravenous, Male, Middle Aged, Pulmonary Artery, Pulmonary Embolism, Risk Factors, Romania, Streptokinase, Time Factors, Thrombolytic Therapy, Treatment Outcome

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CoChat. (2026). Citation check: Systemic or local thrombolysis in high-risk pulmonary embolism. https://app.cochat.ai/papers/10.5603/cj.a2014.0103
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Macovei, L., Presura, R. M., & Arsenescu Georgescu, C. (2015). Systemic or local thrombolysis in high-risk pulmonary embolism. Cardiology Journal. https://doi.org/10.5603/cj.a2014.0103

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