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 accessAbstract
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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“Weidentified 1 systematic review, 218 1 relevant controlled trial (n 5 52), 219 and 3 relevant observational studies (matched population 5 7502). 220-222”
From American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism (2020) · cites this paper as [219]
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Thrombolytics for venous thromboembolic events: a systematic review with meta-analysis
Izcovich, A., Criniti, J. M., Popoff, F., Lu, L., Wu, J., Ageno, W., Witt, D. M., Jaff, M. R., Schulman, S., Manja, V., et al. (2020) · Blood Advances · doi:10.1182/bloodadvances.2020001513 · Cited by 31
Role of Shear Stress and tPA Concentration in the Fibrinolytic Potential of Thrombi
Whyte, C. S., Mostefai, H. A., Baeten, K. M., Lucking, A. J., Newby, D. E., Booth, N. A., & Mutch, N. J. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22042115 · Cited by 23
Metadata
- Authors
- Macovei, L., Presura, R. M., & Arsenescu Georgescu, C.
- Affiliations
- Grigore T. Popa University of Medicine and Pharmacy (RO)
- ORCID
- Macovei, Liviu
- Venue
- Cardiology Journal
- Publisher
- VM Media SP. zo.o VM Group SK
- 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
- gold
- doi.org
- 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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