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Locoregional thrombolysis in the ED for pulmonary embolism

By G. Borsetti, P. Morandi, M. Bigoni, R. Galeotti and S. Sala


Pulmonary thromboembolic disease (PTED) is still a highly topical question in emergency departments . We have thus retrospectively evaluated the 53 patients treated by us (26 men and 27 women, aged 39 to 84 years), focusing a subgroup treated with locoregional thrombolysis.\ud It consist of a bolus dose of 3,300 IU/kg of urokinase in rapid infusion in 10 minutes, followed by a maintenance dose of 1,000/ 1,500 IU/kg hr in infusion by means of a peristaltic pump . Of 53 patients, 8 were treated with locoregional throbolysis after a preliminary angiogram which was concordant to HCT None of these patients had hemorragic complications Of the 45 patients not thrombolysed, 32 were treated with unfractioned IV heparin whereas the remaining 13 patients were treated with low molecular weight heparin. In comparison with systemic thrombolytic therapy, locoregional thrombolysis would seem to involve a lower hemorrhagic risk. The rapid clinical improvement (confirmed by the average length of hospital stays) seems sufficiently encouraging to continue in the direction of local therapy

Topics: pulmonary embolism, locoregional thrombolysis
Year: 2004
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