Contemporary Pulmonary Embolism Thrombolysis

¹ From the Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston

Lack of familiarity with pulmonary embolism (PE) thrombolysis is understandable because most hospitals treat just a few patients each year with recognized massive PE. Therefore, most physicians are inexperienced in administering PE thrombolysis, even though they utilize these agents routinely for acute myocardial infarction. Current estimates are that no more than 10% of patients with PE receive thrombolysis in the United States. This situation may be changing now, because PE thrombolysis appears to have expanded indications. Contemporary PE thrombolysis can now be given with simpler, less expensive protocols than were previously available. In the past, this treatment strategy had been rightly regarded as a heroic measure that consumed hospital resources and physicians' time. Today, PE thrombolysis can be applied with a 2 week "time window," no mandatory angiography in many cases, a brief infusion through a peripheral vein, and no special laboratory tests.