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 Printable version |
Indications and modalities of fibrinolytic therapy for pulmonary embolism |
Sang Thrombose Vaisseaux. Volume 21, Number 4, 181-5, avril 2009, Mini-revue
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 Résumé
Texte intégral
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Author(s) : Guy Meyer, Olivier Sanchez |
Summary : Pulmonary embolism with cardiogenic shock is associated with a 25 to 50% mortality rate. Although no large randomized clinical trial is available, some insights of a meta-analysis suggest that thrombolysis decreases mortality in these patients. In patients without clinical evidence of haemodynamic impairment, the mortality rate is much lower and does not justify more aggressive therapy other than anticoagulants. Recent data, however, suggest that some clinically stable patients may have a higher mortality risk. These so called submassive pulmonary embolisms are characterised either by right ventricular dysfunction assessed by echocardiography or by raised troponin or brain natriuretic peptide. The role of thrombolytic treatment in these patients remains controversial. A large randomized controlled trial is under way to resolve the debate. |
Keywords : pulmonary embolism, thrombolysis |
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