Abstract
Background
This systemic review provides practicing emergency physicians updated information
about the role of thrombolysis in the treatment of intermediate-risk pulmonary embolism.
Methods
A PubMed literature search from January 1, 2005 to December 31, 2018 was conducted
and limited to human clinical trials written in English with relevant keywords. High-quality
studies were identified and then underwent a structured review. Recommendations are
made based on the literature review.
Results
Sixty-three articles met criteria for rigorous review, of which 13 were appropriate
for citation in this review. Of these 13, there were 6 prospective studies and 7 retrospective
studies.
Conclusions
Thrombolysis, either catheter-directed or systemic, is a treatment option in the management
of patients with intermediate-risk pulmonary embolism and a high likelihood of clinical
deterioration. Each method of thrombolysis carries risks and benefits. Based on the
available evidence, transfer to a facility for the purpose of catheter-directed thrombolysis
is not recommended.
Keywords
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Article info
Publication history
Published online: August 30, 2019
Accepted:
June 15,
2019
Received:
May 8,
2019
Footnotes
This Clinical Practice Paper was approved by the American Academy of Emergency Medicine Clinical Guidelines Committee.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
