Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism

YILMAZER UÇAR, Elif

doi:10.5152/eurasianjmed.2019.19291

Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism

Elif YILMAZER UÇAR (Atatürk Üniversitesi)

Eurasian Journal of Medicine

8 2

Yıl: 2019 Cilt: 51 Sayı: 2 Sayfa Aralığı: 186 - 190 Metin Dili: İngilizce DOI: 10.5152/eurasianjmed.2019.19291 İndeks Tarihi: 24-04-2020

Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism

Öz:

Thrombolytic treatment accelerates the dissolution of thrombus in acute pulmonary thromboembolism (PTE) and is potentially a lifesaving treatment. High-risk PTE is the clearest indication for this therapy, and its use in intermediate-risk cases is still controversial. A PTE response team may enable a rapid and effective determination of risk and treatment in these controversial clinical cases. Approved thrombolytic agents for the PTE treatment are streptokinase, urokinase, and alteplase. Currently, the most widely used agent is alteplase. It has a short infusion time (2 h) and a rapid effect. Newer, unapproved agents for the PTE treatment are tenecteplase and reteplase. The active resolution of thrombus via thrombolytic agents improves rapidly pulmonary perfusion, hemodynamic defect, gas exchange, and right ventricular dysfunction. However, it is important to determine appropriate candidates carefully, to prevent hemorrhage, which is the most important side effect of these drugs. Catheter-directed thrombolysis seems to be an alternative in patients not eligible for systemic thrombolytic therapy.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1 Jaff MR, McMurtry MS, Archer SL, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation 2011; 123: 1788-830. [CrossRef]
2. Aissaoui N, Konstantinides S, Meyer G. What's new in severe pulmonary embolism? Intensive Care Med 2019; 45: 75-7. [CrossRef]
3. Konstantinides SV, Torbicki A, Agnelli G, et al. Corrigendum to: 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2015; 36: 2642. [CrossRef]
4. Yamamoto T. Management of patients with high-risk pulmonary embolism: a narrative review. J Intensive Care 2018; 6: 16. [CrossRef]
5. Blanco-Molina A, Rota LL, Di Micco P, et al. Venous thromboembolism during pregnancy, postpartum or during contraceptive use. Thromb Haemost 2010; 103: 306-11. [CrossRef]
6. Borohovitz A, Weinberg M2, Weinberg I. Pulmonary embolism: Care standards in 2018. Prog Cardiovasc Dis 2018; 60: 613-21. [CrossRef]
7. Meral M, Mirici A, Aslan S, et al. Barometric pressure and the incidence of pulmonary embolism. Chest 2005; 128: 2190-4. [CrossRef]
8. Akgun M, Meral M, Onbas O, et al. Comparison of clinical characteristics and outcomes of patients with COPD exacerbation with or without venous thromboembolism. Respiration 2006; 73: 428-33. [CrossRef]
9. Ucar EY, Araz O, Akgun M, et al. Low-molecular-weight heparin use with thrombolysis: is it effective and safe? Ten years' clinical experience. Respiration 2013; 86: 318-23. [CrossRef]
10. Rali PM, Criner GJ. Submassive Pulmonary Embolism. Am J Respir Crit Care Med 2018; 198: 588-98. [CrossRef]
11. Barnes GD, Kabrhel C, Courtney DM, et al. Diversity in the Pulmonary Embolism Response Team Model: An Organizational Survey of the National PERT Consortium Members. Chest 2016; 150: 1414-7. [CrossRef]
12. Coutance G, Cauderlier E, Ehtisham J, Hamon M, Hamon M. The prognostic value of markers of right ventricular dysfunction in pulmonary embolism: a meta-analysis. Crit Care 2011; 15: R103. [CrossRef]
13. Sanchez O, Trinquart L, Colombet I, et al. Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review. Eur Heart J 2008; 29: 1569-77. [CrossRef]
14. Stein PD, Matta F. Thrombolytic therapy in unstable patients with acute pulmonary embolism: saves lives but underused. Am J Med 2012; 125: 465-70. [CrossRef]
15. Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet 1993; 341: 507-11. [CrossRef]
16. Arcasoy SM, Vachani A. Local and systemic thrombolytic therapy for acute venous thromboembolism. Clin Chest Med 2003; 24: 73-91. [CrossRef]
17. Emmerich J, Meyer G, Decousus H, Agnelli G. Role of fibrinolysis and interventional therapy for acute venous thromboembolism. Thromb Haemost 2006; 96: 251-7. [CrossRef]
18. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest 2016; 149: 315-52. [CrossRef]
19. Wan S, Quinlan DJ, Agnelli G, Eikelboom JW. Thrombolysis compared with heparin for the initial treatment of pulmonary embolism: a meta-analysis of the randomized controlled trials. Circulation 2004; 110: 744-9. [CrossRef]
20. Chatterjee S, Chakraborty A, Weinberg I, et al. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA 2014; 311: 2414-21. [CrossRef]
21. Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 2014; 370: 1402-11. [CrossRef]
22. Kucher N, Boekstegers P, Müller OJ, et al. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation 2014; 129: 479-86. [CrossRef]
23. Engelberger RP, Moschovitis A, Fahrni J, et al. Fixed low-dose ultrasound-assisted catheter-directed thrombolysis for intermediate and high-risk pulmonary embolism. Eur Heart J 2015; 36: 597-604. [CrossRef]
24. Kuo WT, Banerjee A, Kim PS, et al. Pulmonary Embolism Response to Fragmentation, Embolectomy, and Catheter Thrombolysis (PERFECT): Initial Results From a Prospective Multicenter Registry. Chest 2015; 148: 667-73. [CrossRef]
25. Kline JA, Nordenholz KE, Courtney DM, et al. Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicenter double-blind, placebo-controlled randomized trial. J Thromb Haemost 2014; 12: 459-68. [CrossRef]
26. van der Meer RW, Pattynama PM, van Strijen MJ, et al. Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3-month follow-up in patients with acute pulmonary embolism. Radiology 2005; 235: 798-803. [CrossRef]
27. Tapson VF, Weinberg AS. Thrombolytic (fibrinolytic) therapy in acute pulmonary embolism and lower extremity deep vein thrombosis. https://www.uptodate.com/contents/thrombolytic-fibrinolytic-therapy-in-acute-pulmonary-embolism-and-lower-extremity-deep-vein thrombosis, 2019.
28. Miller GA, Sutton GC, Kerr IH, Gibson RV, Honey M. Comparison of streptokinase and heparin in treatment of isolated acute massive pulmonary embolism. Br Heart J 1971; 33: 616. [CrossRef]
29. The urokinase pulmonary embolism trial. A national cooperative study. Circulation 1973; 47: II1-108.
30. Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet 1993; 341: 507-11. [CrossRef]
31. Schulman S, Ageno W, Konstantinides SV. Venous thromboembolism: Past, present and future. Thromb Haemost 2017; 117: 1219-29. [CrossRef]
32. Butcher K, Shuaib A, Saver J, et al. Thrombolysis in the developing world: is there a role for streptokinase? Int J Stroke 2013; 8: 560-5. [CrossRef]
33. Tapson VF. Thrombolytic therapy for acute pulmonary embolism. Semin Thromb Hemost 2013; 39: 452-8. [CrossRef]
34. Goldhaber SZ. Thrombolysis in pulmonary embolism: a debatable indication. Thromb Haemost 2001; 86: 444-51. [CrossRef]
35. Sinnaeve P, Alexander J, Belmans A, et al. One-year follow-up of the ASSENT-2 trial: a double-blind, randomized comparison of single-bolus tenecteplase and front-loaded alteplase in 16,949 patients with ST-elevation acute myocardial infarction. Am Heart J 2003; 146: 27-32. [CrossRef]
36. Ucar EY, Akgun M, Araz O, et al. Comparison of LMWH versus UFH for hemorrhage and hospital mortality in the treatment of acute massive pulmonary thromboembolism after thrombolytic treatment: randomized controlled parallel group study. Lung 2015; 193: 121-7. [CrossRef]
37. Senturk A, Ucar EY, Berk S, et al. Should Low-Molecular-Weight Heparin be Preferred Over Unfractionated Heparin After Thrombolysis for Severity Pulmonary Embolism? Clin Appl Thromb Hemost 2016; 22: 395-9. [CrossRef]
38. Wang C, Zhai Z, Yang Y, et al. Efficacy and safety of lowdose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest 2010; 137: 254-62. [CrossRef]
39. Zhang Z, Zhai ZG, Liang LR, Liu FF, Yang YH, Wang C. Lower dosage of recombinant tissue-type plasminogen activator (rt-PA) in the treatment of acute pulmonary embolism: a systematic review and metaanalysis.Thromb Res 2014; 133: 357-63. [CrossRef]
40. Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M; "MOPETT" Investigators. Moderate pulmonary embolism treated with thrombolysis (from the "MOPETT" Trial). Am J Cardiol 2013; 111: 273-7. [CrossRef]
41. Jimenez D, Martin-Saborido C, Muriel A, et al. Efficacy and safety outcomes of recanalisation procedures in patients with acute symptomatic pulmonary embolism: systematic review and network meta-analysis. Thorax 2018; 73: 464-71. [CrossRef]
42. Yilmazel Ucar E, Araz O, Kerget B, Yilmaz N, Akgun M, Saglam L. Comparison of long-term outcomes of 50 and 100 mg rt-PA in the management of acute pulmonary thromboembolism. Clin Respir J 2018; 12: 1628-34. [CrossRef]
43. Piazza G, Hohlfelder B, Jaff MR, et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. JACC Cardiovasc Interv 2015; 8: 1382-92. [CrossRef]
44. Akin H, Al-Jubouri M, Assi Z, Acino R, Sepanski D, Comerota AJ. Catheter-directed thrombolytic intervention is effective for patients with massive and submassive pulmonary embolism. Ann Vasc Surg 2014; 28: 1589-94. [CrossRef]
45. McCabe JM, Huang PH, Riedl L, Eisenhauer AC, Sobieszczyk P. Usefulness and safety of ultrasound-assisted catheter-directed thrombolysis for submassive pulmonary emboli. Am J Cardiol 2015; 115: 821-4. [CrossRef]
46. Halaby R, Giri J. Keep it simple? Half-dose systemic thrombolysis or catheter-directed thrombolysis for pulmonary embolism. Vasc Med 2019; 24: 110-1. [CrossRef]
47. Sharifi M, Awdisho A, Schroeder B, Jiménez J, Iyer P, Bay C. Retrospective comparison of ultrasound facilitated catheter-directed thrombolysis and systemically administered half-dose thrombolysis in treatment of pulmonary embolism. Vasc Med 2019; 24: 103-9. [CrossRef]
48. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353: 1386-9. [CrossRef]
49. Bircan HA, Alanoglu EG. Massive Pulmonary Embolism in a Patient with Heparin Induced Thrombocytopenia: Successful Treatment with Dabigatran. Eurasian J Med 2016; 48: 65-8. [CrossRef]
50. Piazza G, Goldhaber SZ. Fibrinolysis for acute pulmonary embolism. Vasc Med 2010; 15: 419-28. [CrossRef]
51. Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Massive pulmonary embolism. Circulation 2006; 113: 577-82. [CrossRef]

APA	YILMAZER UÇAR E (2019). Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. , 186 - 190. 10.5152/eurasianjmed.2019.19291
Chicago	YILMAZER UÇAR Elif Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. (2019): 186 - 190. 10.5152/eurasianjmed.2019.19291
MLA	YILMAZER UÇAR Elif Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. , 2019, ss.186 - 190. 10.5152/eurasianjmed.2019.19291
AMA	YILMAZER UÇAR E Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. . 2019; 186 - 190. 10.5152/eurasianjmed.2019.19291
Vancouver	YILMAZER UÇAR E Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. . 2019; 186 - 190. 10.5152/eurasianjmed.2019.19291
IEEE	YILMAZER UÇAR E "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism." , ss.186 - 190, 2019. 10.5152/eurasianjmed.2019.19291
ISNAD	YILMAZER UÇAR, Elif. "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism". (2019), 186-190. https://doi.org/10.5152/eurasianjmed.2019.19291

APA	YILMAZER UÇAR E (2019). Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. Eurasian Journal of Medicine, 51(2), 186 - 190. 10.5152/eurasianjmed.2019.19291
Chicago	YILMAZER UÇAR Elif Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. Eurasian Journal of Medicine 51, no.2 (2019): 186 - 190. 10.5152/eurasianjmed.2019.19291
MLA	YILMAZER UÇAR Elif Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. Eurasian Journal of Medicine, vol.51, no.2, 2019, ss.186 - 190. 10.5152/eurasianjmed.2019.19291
AMA	YILMAZER UÇAR E Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. Eurasian Journal of Medicine. 2019; 51(2): 186 - 190. 10.5152/eurasianjmed.2019.19291
Vancouver	YILMAZER UÇAR E Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism. Eurasian Journal of Medicine. 2019; 51(2): 186 - 190. 10.5152/eurasianjmed.2019.19291
IEEE	YILMAZER UÇAR E "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism." Eurasian Journal of Medicine, 51, ss.186 - 190, 2019. 10.5152/eurasianjmed.2019.19291
ISNAD	YILMAZER UÇAR, Elif. "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism". Eurasian Journal of Medicine 51/2 (2019), 186-190. https://doi.org/10.5152/eurasianjmed.2019.19291