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* From the Pulmonary and Critical Care Division (Dr. Arcasoy), University of Pennsylvania School of Medicine, Philadelphia, PA; and the Division of Pulmonary, Allergy and Critical Care Medicine (Dr. Kreit), University of Pittsburgh School of Medicine, Pittsburgh, PA.
Pulmonary embolism (PE) is a common disorder that is accompanied by significant morbidity and mortality. Although anticoagulation is the standard treatment for PE, thrombolytic therapy, with its ability to produce rapid clot lysis, has long been considered an attractive alternative. Although many studies have been performed over the past three decades, however, the indications for the use of thrombolytic agents in patients with PE remain controversial. In this article, we review the medical literature and provide evidence-based guidelines for the use of thrombolytic therapy. We will also discuss the practical aspects of PE thrombolysis.
Key Words: fibrinolysis • pulmonary embolism • recombinant tissue-type plasminogen activator • streptokinase • thrombolytic therapy • urokinase
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