Thrombolytic therapy for postoperative pulmonary embolism

摘要: Abstract The use of thrombolytic agents in the treatment postoperative pulmonary embolism presents a dilemma to surgeon. On one hand, usually occurs within 2 weeks surgery. other recent surgery is considered contraindication for thrombolytics. We developed protocol treating patients who have recently undergone Urokinase, at dose 2,200 U/kg wt, injected directly into clot via catheter positioned artery. This followed by continuous infusions urokinase wt/hr until lysed (up 24 hrs). Simultaneously, heparin administered peripherally 500 U/hr. level serum fibrinogen monitored every 6 hours and maintained no less than 0.2 g/dL prevent bleeding. Thirteen were treated angiographically proven 14 days Complete lysis embolus was achieved, deaths or bleeding complications occurred. Two received inferior vena cava filters, nine longer needed chronic anticoagulants 3 months after embolic event.