1 / 18

EFFECTIVENESS OF THROMBOLYTIC THERAPY IN PULMONARY THROMBOEMBOLISM

EFFECTIVENESS OF THROMBOLYTIC THERAPY IN PULMONARY THROMBOEMBOLISM. Gülfer Okumuş*, Rabia Ünver*, Esen Kıyan*, Halim İşsever**, Orhan Arseven* Istanbul University, Istanbul Medical Faculty, *Department of Pulmonary Disease, **Department of Public Health. Introductio n.

alden
Télécharger la présentation

EFFECTIVENESS OF THROMBOLYTIC THERAPY IN PULMONARY THROMBOEMBOLISM

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. EFFECTIVENESS OF THROMBOLYTIC THERAPY IN PULMONARY THROMBOEMBOLISM Gülfer Okumuş*, Rabia Ünver*, Esen Kıyan*, Halim İşsever**, Orhan Arseven* Istanbul University, Istanbul Medical Faculty, *Department of Pulmonary Disease, **Department of Public Health

  2. Introduction • Thrombolytic agents activate plasminogen to form plasmin, resulting in the accelerated lysis of thrombi. • The studies suggest that thrombolytic therapy accelerates clot lysis and is associated with short-term physiologic benefits. • It is a life saving treatment in massive PTE.

  3. Indications for thrombolytic therapy • Presence of hypotension related to PE • Presence of severe hypoxemia • Substantial perfusion defect • Right ventricular dysfunction associated with PE • Extensive deep vein thrombosis

  4. Contraindications for thrombolytic therapy Absolute • History of hemorrhagic stroke • Active intracranial neoplasm • Recent (< 2 months) intracranial surgery or trauma • Active or recent internal bleeding in prior 6 months

  5. Contraindications for thrombolytic therapy Relative • Bleeding diathesis • Uncontrolled severe hypertension (systolic BP >200 mmHg or diastolic BP >110 mmHg) • Nonhemorrhagic stroke within prior 2 months • Surgery within the previous 10 days • Thrombocytopenia (<100,000 platelets per mm3)

  6. Adverse effects • Bleeding (most common) • Thrombolytic agent-specific adverse reactions • Streptocynase is associated with: • Allergic reactions • Hypotension

  7. Aim • To investigate the effectiveness of thrombolytic therapy in patients with PTE.

  8. Material and Methods • January 2001- December 2006 • 37 patients with PTE • Patients’ demographic, clinic and laboratory characteristics was recorded • The echocardiographic findings were added. • ECHO; before treatment within 24 hours • After treatment within 48 hours

  9. Statistical analysis • T-test • NPar test • Wilcoxon test

  10. Results • 17 females, 20 males • Age= 52.5±17.1 years (16-74years). • 30 patients  CT (+) • 21 patients  Proximal DVT (+) • Systolic BP= 9018mmHg (80-120mmHg) • Diastolic BP= 6011mmHg (50-80mmHg)

  11. Results • Streptocynase  27 patients • Tissue plasminogen activator ( rTPA)  10 patients • Streptocynase (in patients with DVT) • In six patients 48 hours, • In four patients 72 hours

  12. Results • PAP=61.1±22.2mmHg (40-110 mmHg) (before) • PAP=41.6±23.8mmHg (20-100mmHg)(after) x2=5.44; p<0.0001

  13. Results • 31 patients  No complications • Three patients  Minor complications

  14. Results • Three patients  Major complications • Hemothorax (Streptocynase in the 24th hour)(3.1%) • Hypotension (Streptocynase in the 24th hour) • Hypertension (rTPA in the first hour). No patients died due to the thrombolytic therapy

  15. Conclusion In our study, • Thrombolytic therapy significantly decreased the pulmonary arterial pressure. • Complication rate due to the treatment was low.

  16. THANK YOU...

More Related