Back to Journals » Drug Design, Development and Therapy » Volume 8

Thrombolytic treatment (alteplase; rt-PA) in acute massive pulmonary embolism and cardiopulmonary arrest

Authors Dirican A, Ozkaya S, Atas A, Ulu E, Kitapci I, Ece F, Gokhan E

Received 31 January 2014

Accepted for publication 2 April 2014

Published 12 June 2014 Volume 2014:8 Pages 759—763


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Adem Dirican,1 Sevket Ozkaya,2 Ali Ekber Atas,3 Esra Kayahan Ulu,4 Ilknur Kitapci,5 Ferah Ece2

Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahçesehir University, Istanbul, Turkey; 3Department of Cardiology, Medical Park Samsun Hospital, Samsun, Turkey; 4Department of Radiology, Medical Park Samsun Hospital, Samsun, Turkey; 5Department of Intensive Care Unit, Medical Park Samsun Hospital, Samsun, Turkey

Abstract: Patients with pulmonary thromboembolism (PE) often decompensate suddenly, and once hemodynamic compromise has developed, mortality is extremely high. Currently, thrombolytic therapy for PE is still controversial. We retrospectively evaluated 34 patients with PE between January 2010 and December 2013 in the Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey. The demographic and disease characteristics of patients who received thrombolytic treatment were retrospectively analyzed. The female to male ratio was 19/15 and the mean age was 63.1±13.2 years. PE diagnosis was made using echocardiography (64.7%) or contrast-enhanced thorax computed tomography with echocardiography (32.4%). Twenty-two (64.7%) patients went into the cardiopulmonary arrest due to massive PE and 17 (50%) patients recovered without sequelae. Eleven (32.4%) patients were diagnosed with massive PE during cardiopulmonary arrest with clinical and echocardiographic findings. Alteplase (recombinant tissue plasminogen activator [rt-PA]) was administered during cardiopulmonary resuscitation (CPR) and four (36.3%) patients responded and survived without sequelae. The complications of rt-PA treatment were hemorrhage in five (14.7%) patients and allergic reactions in two (5.9%) patients. There was no mortality due to rt-PA treatment complications. In conclusion, mortality due to massive PE is much more than estimated and alteplase can be used safely in patients with massive PE. This thrombolytic treatment was not associated with any fatal hemorrhage complication. If there is any sign of acute PE, echocardiography should be used during cardiopulmonary arrest/instability. Alteplase should be given to patients with suspected massive PE.

Keywords: massive pulmonary embolism, thrombolytic treatment, rt-PA, cardiopulmonary arrest, resuscitation, mortality, hemorrhage

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Factors affecting patients’ comfort during fiberoptic bronchoscopy and endobronchial ultrasound

Yıldırım F, Özkaya Ş, Yurdakul AS

Journal of Pain Research 2017, 10:775-781

Published Date: 29 March 2017

The objective evaluation of obstructive pulmonary diseases with spirometry

Ozkaya S, Dirican A, Tuna T

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:2009-2015

Published Date: 25 August 2016

The rapid effects of budesonide plus formoterol in patients with obstructive airway diseases

Bayiz H, Ozkaya S, Dirican A, Ece F

Drug Design, Development and Therapy 2015, 9:5287-5290

Published Date: 21 September 2015

The relationship between early reversibility test and maximal inspiratory pressure in patients with airway obstruction

Ozkaya S, Dirican A, Kaya SO, Karanfil RC, Bayrak MG, Bostancı O, Ece F

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:453-456

Published Date: 5 May 2014

Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

Sarac A, Jahollari A, Talay S, Ozkaya S, Ozal E

Clinical Interventions in Aging 2014, 9:575-579

Published Date: 5 April 2014

Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease

Tuna T, Ozkaya S, Dirican A, Findik S, Atici AG, Erkan L

OncoTargets and Therapy 2013, 6:1553-1557

Published Date: 5 November 2013

The utility of tumor markers CA 125, CA 15-3, and CA 19-9 in assessing the response to therapy in pulmonary and pleural tuberculosis

Tasci C, Ozkaya S, Ozkara B, Tozkoparan E, Ozkan M, Karadurmus N, Serdar M, Balkan A, Bilgic H

OncoTargets and Therapy 2012, 5:385-390

Published Date: 22 November 2012

The costs of hospitalization in patients with acute exacerbation of chronic obstructive pulmonary disease

Sevket Ozkaya, Serhat Findik, Atilla Guven Atici

ClinicoEconomics and Outcomes Research 2011, 3:15-18

Published Date: 17 January 2011

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010