Major pulmonary embolism, part 3: A practical treatment strategy

Kenneth E. Wood, Aaron Joffe

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In patients with major pulmonary embolism (PE), clot lysis is achieved more rapidly with thrombolytic therapy than with heparin alone. Therefore, thrombolytic therapy is the treatment of choice for many patients with major PE. There do not appear to be any significant differences among the thrombolytic agents, provided they are given in equivalent doses over the same time frame. Intravenous unfractionated heparin should be used for 7 to 10 days; substantial dosages (40,000 U/d or more) may be required. Surgical embolectomy is indicated rarely but may be appropriate for patients in whom thrombolytic therapy clearly has failed or who cannot tolerate such therapy. Catheter embolectomy is an alternative for patients who are not in full cardiac arrest. Placement of an inferior vena caval filter should be considered in patients who have major PE and documented residual deep venous thrombosis.

Original languageEnglish (US)
Pages (from-to)446-451
Number of pages6
JournalJournal of Respiratory Diseases
Issue number10
StatePublished - Oct 2003

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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