Turk Kardiyol Dern Ars. 2010; 38(6): 432-435

Repeated prolonged thrombolytic therapy after unsuccessful thrombolysis in massive pulmonary embolism: a case report

Hüseyin Uğur Yazıcı, Burak Akçay, Abdurrahman Tasal, Ünal Öztürk
Diyarbakır Education And Research Hospital, Department of Cardiology, Diyarbakır, Turkey

We report on a 43-year-old woman who presented with shortness of breath and syncope due to massive pulmonary embolism. Transthoracic echocardiography showed signs of right ventricular overload, and contrast-enhanced chest computed tomography demonstrated filling defects in both main pulmonary arteries consistent with obstructing thrombi. Initially, thrombolytic therapy with recombinant tissue plasminogen activator was given, but shock was not resolved. Thrombolytic therapy was repeated with streptokinase and infusion was extended to 48 hours, which yielded a successful result without any hemorrhagic complication. Repeated prolonged thrombolytic therapy after initial unsuccessful thrombolysis can be considered an alternative option in massive pulmonary embolism.

Keywords: Pulmonary embolism/drug therapy, streptokinase/therapeutic use, thrombolytic therapy/methods, tissue plasminogen activator/therapeutic use

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