Successful thrombolysis in postoperative patients with acute massive pulmonary embolism

Kedong Zhang, Xiansheng Zeng, Caixia Zhu, Lei Xu, Xin Fu, Hua Jiang, Jian Wang, Wenju Lu

Research output: Contribution to journalArticle

Abstract

Purpose: The standard medical management for patients with acute massive pulmonary embolism (MPE) is systemic thrombolysis. However, it is generally thought that recent surgeries are a contraindication to thrombolytic therapy. In this study, we evaluated the efficacy and safety of systemic thrombolysis for postoperative patients with acute MPE and assessed the risk of bleeding. Methods: A retrospective review was performed on 21 postoperative patients with MPE in a timeframe of five years (from 2005 to 2010). The criteria for study inclusion were postoperative patients who received systemic thrombolysis for confirmed acute MPE within three weeks after surgery. Results: Seventeen postoperative patients, including men (12) and women (five) aged 53 ± 16 (range 23-71) years, were treated with systemic thrombolysis. Significant haemodynamic improvement (shock index < 0.9) was observed in 16 of 17 cases (94%). The remaining patient (6%) died of cardiac arrest within 24. h. No major bleeding complication was observed. Sixteen patients survived and remained stable for 34 ± 16 (range 11-52) days until hospital discharge. Conclusion: Recent surgery is not an absolute contraindication to systemic thrombolysis. Further, to obtain a successful outcome, it is crucial to exclude patients who have received neurosurgical operations or those with other contraindications to thrombolytic therapy.

Original languageEnglish (US)
Pages (from-to)100-103
Number of pages4
JournalHeart Lung and Circulation
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • Acute massive pulmonary embolism
  • Postoperative thrombolysis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Zhang, K., Zeng, X., Zhu, C., Xu, L., Fu, X., Jiang, H., Wang, J., & Lu, W. (2013). Successful thrombolysis in postoperative patients with acute massive pulmonary embolism. Heart Lung and Circulation, 22(2), 100-103. https://doi.org/10.1016/j.hlc.2012.08.055