폐색전증에서 혈전용해
- Author(s)
- 최원일
- Keimyung Author(s)
- Choi, Won Il
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- 대한내과학회지
- Issued Date
- 2013
- Volume
- 84
- Issue
- 1
- Abstract
- The standard therapy for acute pulmonary embolism is initiated with heparin. Massive pulmonary embolism (PE) is defined by
the presence of cardiogenic shock, persistent arterial hypotension, or both. It is associated with a high risk of in-hospital death, particularly
during the first hours after admission. Thrombolysis is recommended in massive PE. Results from a randomized trial suggested
that selected patients with evidence of right ventricular dysfunction and a low risk of bleeding may benefit from
thrombolysis. In this issue of the Journal, Kim Yang-Ki and colleagues conducted retrospective review of thrombolytic therapy in
PE last 6.5 years in a single center. The mortality rate of massive PE (44%) was higher than submassive PE (8%) in patients with
thrombolysis. Major bleeding occurred in 3/21 (14%) patients. This signal reminds us “real-world” hazards of thrombolysis is higher
than randomized controlled trial. Although massive PE patients need more intensifying therapy to reduce mortality, we should
careful assessment of bleeding risk factors before starting thrombolysis. With regard to submassive PE, this study has limitation to
assessing the efficacy of thrombolysis. (Korean J Med 2013;84:46-48)
Keywords: Pulmonary embolism; Thrombolysis; Bleeding
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