open access

Vol 88, No 1 (2020)
CLINICAL VIGNETTES
Published online: 2020-02-28
Submitted: 2019-11-21
Accepted: 2020-01-13
Get Citation

Defying the paradigm — rescue thrombolysis in a postoperative patient with pulmonary embolism

Kunal Deokar, Ram Niwas, Nishant Chauhan, Gopal Chawla
DOI: 10.5603/ARM.2020.0079
·
Pubmed: 32153008
·
Adv Respir Med 2020;88(1):37-38.

open access

Vol 88, No 1 (2020)
CLINICAL VIGNETTES
Published online: 2020-02-28
Submitted: 2019-11-21
Accepted: 2020-01-13

Abstract

Parenteral anticoagulation is recommended for patients of intermediate — high early mortality risk pulmonary embolism. Rescue reperfusion is considered if signs of hemodynamic decompensation appear. Recent surgery is a contraindication to thrombolysis. Percutaneous catheter directed thrombolysis and surgical embolectomy can be done in such patients. However, they are not readily available. We hereby report a case of rescue thrombolysis in a post lower segment caesarean section (LSCS) patient with pulmonary thromboembolism. We could successfully achieve thrombolysis in our patient with improvement in clinical and hemodynamic parameters and with no major bleeding from any site.

Abstract

Parenteral anticoagulation is recommended for patients of intermediate — high early mortality risk pulmonary embolism. Rescue reperfusion is considered if signs of hemodynamic decompensation appear. Recent surgery is a contraindication to thrombolysis. Percutaneous catheter directed thrombolysis and surgical embolectomy can be done in such patients. However, they are not readily available. We hereby report a case of rescue thrombolysis in a post lower segment caesarean section (LSCS) patient with pulmonary thromboembolism. We could successfully achieve thrombolysis in our patient with improvement in clinical and hemodynamic parameters and with no major bleeding from any site.

Get Citation

Keywords

pulmonary embolism; CTPA; thrombolysis

About this article
Title

Defying the paradigm — rescue thrombolysis in a postoperative patient with pulmonary embolism

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 1 (2020)

Pages

37-38

Published online

2020-02-28

DOI

10.5603/ARM.2020.0079

Pubmed

32153008

Bibliographic record

Adv Respir Med 2020;88(1):37-38.

Keywords

pulmonary embolism
CTPA
thrombolysis

Authors

Kunal Deokar
Ram Niwas
Nishant Chauhan
Gopal Chawla

References (7)
  1. Konstantinides SV, Torbicki A, Agnelli G. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 2014; 35(43): 3033–3080.
  2. Cable DG, Cherry KJ. Systemic thrombolytic therapy after recent abdominal aortic aneurysm repair: an absolute contraindication? Mayo Clin Proc. 2003; 78(1): 99–102.
  3. Koroneos A, Koutsoukou A, Zervakis D, et al. Successful resuscitation with thrombolysis of a patient suffering fulminant pulmonary embolism after recent intracerebral haemorrhage. Resuscitation. 2007; 72(1): 154–157.
  4. Han S, Chaya C, Hoo GW. Thrombolytic therapy for massive pulmonary embolism in a patient with a known intracranial tumor. J Intensive Care Med. 2006; 21(4): 240–245.
  5. Allport LE, Butcher KS. Thrombolysis for concomitant acute stroke and pulmonary embolism. J Clin Neurosci. 2008; 15(8): 917–920.
  6. Zhang K, Zeng X, Zhu C, et al. Successful thrombolysis in postoperative patients with acute massive pulmonary embolism. Heart Lung Circ. 2013; 22(2): 100–103.
  7. Bottinor W, Turlington J, Raza S, et al. Life-saving systemic thrombolysis in a patient with massive pulmonary embolism and a recent hemorrhagic cerebrovascular accident. Tex Heart Inst J. 2014; 41(2): 174–176.

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