Original Article
Heparin plus Alteplase Compared with Heparin Alone in Patients with Submassive Pulmonary Embolism
N Engl J Med 2002; 347:1143-1150October 10, 2002
- Abstract
Background
The use of thrombolytic agents in the treatment of hemodynamically stable patients with acute submassive pulmonary embolism remains controversial.
Methods
We conducted a study of patients with acute pulmonary embolism and pulmonary hypertension or right ventricular dysfunction but without arterial hypotension or shock. The patients were randomly assigned in double-blind fashion to receive heparin plus 100 mg of alteplase or heparin plus placebo over a period of two hours. The primary end point was in-hospital death or clinical deterioration requiring an escalation of treatment, which was defined as catecholamine infusion, secondary thrombolysis, endotracheal intubation, cardiopulmonary resuscitation, or emergency surgical embolectomy or thrombus fragmentation by catheter.
Results
Of 256 patients enrolled, 118 were randomly assigned to receive heparin plus alteplase and 138 to receive heparin plus placebo. The incidence of the primary end point was significantly higher in the heparin-plus-placebo group than in the heparin-plus-alteplase group (P=0.006), and the probability of 30-day event-free survival (according to Kaplan–Meier analysis) was higher in the heparin-plus-alteplase group (P=0.005). This difference was due to the higher incidence of treatment escalation in the heparin-plus-placebo group (24.6 percent vs. 10.2 percent, P=0.004), since mortality was low in both groups (3.4 percent in the heparin-plus-alteplase group and 2.2 percent in the heparin-plus-placebo group, P=0.71). Treatment with heparin plus placebo was associated with almost three times the risk of death or treatment escalation that was associated with heparin plus alteplase (P=0.006). No fatal bleeding or cerebral bleeding occurred in patients receiving heparin plus alteplase.
Conclusions
When given in conjunction with heparin, alteplase can improve the clinical course of stable patients who have acute submassive pulmonary embolism and can prevent clinical deterioration requiring the escalation of treatment during the hospital stay.
Media in This Article
Figure 1
Kaplan–Meier Estimates of the Probability of Event-free Survival among Patients with Acute Submassive Pulmonary Embolism, According to Treatment with Heparin plus Alteplase or Heparin plus Placebo.Figure 2
Mean Activated Partial-Thromboplastin Time in Patients with Acute Submassive Pulmonary Embolism, According to Treatment with Heparin plus Alteplase or Heparin plus Placebo.Article Activity
- Article
Thrombolysis is an established treatment for patients with acute massive pulmonary embolism and hemodynamic instability or cardiogenic shock.1 In contrast, the effect of thrombolytic agents on the outcome of hemodynamically stable patients who have submassive pulmonary embolism has been debated for decades.2,3 Several factors have contributed to the ongoing controversy: the lack of a large, randomized study assessing clinical end points,4 the risk of serious hemorrhage associated with thrombolytic therapy,1,5-7 and the fact that patients' hemodynamic status may gradually improve with heparin therapy alone.8,9
The clinical data currently available underscore the need to identify patients in whom thrombolysis may have a favorable risk–benefit ratio. Studies based on two large, multicenter registries reported that patients with right ventricular dysfunction due to pulmonary embolism had increased rates of in-hospital death, even in the absence of arterial hypotension or shock.5,10 These findings are in accord with the results of early experimental studies on the pathophysiology of venous thromboembolism.11 Data from one of these registries also suggested that early thrombolytic therapy might favorably affect the prognosis of these patients.12 We therefore undertook a randomized, placebo-controlled trial to compare the effects of treatment with heparin plus alteplase with the effects of heparin plus placebo on the outcome of patients with acute submassive pulmonary embolism. We focused on patients with pulmonary hypertension, right ventricular dysfunction, or both, but we excluded those with hemodynamic instability.
Methods
Study Population
To be included in the trial, patients with acute pulmonary embolism had to fulfill at least one of the following criteria, which were defined a priori: echocardiographically detected right ventricular dysfunction, defined as right ventricular enlargement combined with loss of inspiratory collapse of the inferior vena cava, without left ventricular or mitral-valve disease12; echocardiographically detected pulmonary-artery hypertension,13 defined as a tricuspid regurgitant jet velocity greater than 2.8 m per second, followed by confirmation of pulmonary embolism (by ventilation–perfusion lung scanning, spiral computed tomography [CT], or pulmonary angiography); a diagnosis of precapillary pulmonary hypertension based on catheterization of the right side of the heart, defined as a mean pulmonary-artery pressure above 20 mm Hg and a pulmonary-capillary wedge pressure below 18 mm Hg, followed by confirmation of pulmonary embolism; or new electrocardiographic signs of right ventricular strain (defined as complete or incomplete right bundle-branch block, S waves in lead I combined with Q waves in lead III, or inverted T waves in precordial leads V1, V2, and V3), followed by confirmation of pulmonary embolism.
Patients were excluded from the study if they had one or more of the following characteristics: age over 80 years; hemodynamic instability, defined as persistent arterial hypotension (i.e., systolic pressure below 90 mm Hg), with or without signs of cardiogenic shock; onset of symptoms more than 96 hours before diagnosis; thrombolytic treatment, major surgery, or biopsy within the preceding 7 days; major trauma within the preceding 10 days; stroke, transient ischemic attack, craniocerebral trauma, or neurologic surgery within the preceding 6 months; gastrointestinal bleeding within the preceding 3 months; uncontrolled hypertension; a known bleeding disorder; known inability to tolerate alteplase; known diabetic retinopathy; current therapy with an oral anticoagulant; current pregnancy or lactation; a life expectancy of less than 6 months because of underlying disease; or planned use of thrombolytic agents for extensive deep-vein thrombosis.
The study protocol was approved by the local ethics committee at each institution. Written informed consent was obtained from all the patients.
Study Design
The study was designed as a prospective, randomized, double-blind, placebo-controlled trial and was conducted between September 1997 and August 2001 at 49 centers in Germany (see the Appendix) by a committee that included all the authors. Patients believed to have acute submassive pulmonary embolism, as previously defined,12 received an intravenous bolus of 5000 U of unfractionated heparin before undergoing further diagnostic workup. Patients who met the inclusion criteria and were enrolled in the study were then randomly assigned to receive 100 mg of alteplase (Actilyse, Boehringer Ingelheim Pharma) as a 10-mg bolus, followed by a 90-mg intravenous infusion over a period of two hours, or matching placebo. Randomization was performed on a 1:1 basis with a fixed block size of six patients at each center, according to a standard randomization program. In addition to alteplase or placebo, patients in both groups received an intravenous infusion of unfractionated heparin. The infusion was started at a rate of 1000 U per hour, and the rate was subsequently adjusted to maintain the activated partial-thromboplastin time at 2.0 to 2.5 times the upper limit of normal. Measurements of the activated partial-thromboplastin time were performed at 6-hour intervals on day 1 after randomization, and at 12-hour intervals thereafter for at least four days. Overlapping oral anticoagulant therapy was started on day 3 after randomization, and the dosage was adjusted to maintain an international normalized ratio of 2.5 to 3.5. The trial protocol permitted breaking of the randomization code if additional therapy had to be provided on an emergency basis to a patient whose condition was deteriorating.
Definition of Clinical End Points
Patients were evaluated at the end of their hospital stay or on day 30 after randomization, whichever occurred first. The primary end point was in-hospital death or clinical deterioration that required an escalation of treatment after the infusion of alteplase or placebo was terminated. Escalation of treatment was defined as the use of at least one of the following: infusion of a catecholamine because of persistent arterial hypotension or shock (except for dopamine infused at a rate no more than 5 μg per kilogram of body weight per minute); secondary, or “rescue,” thrombolysis (for one of the following indications: worsening clinical symptoms, particularly dyspnea, or worsening respiratory failure due to pulmonary embolism; arterial hypotension or shock; and persistent or worsening pulmonary hypertension or right ventricular dysfunction detected by echocardiography or right heart catheterization); endotracheal intubation; cardiopulmonary resuscitation; and emergency surgical embolectomy or thrombus fragmentation by catheter.
The secondary end points of the study were recurrent pulmonary embolism, major bleeding, and ischemic stroke. Recurrence of pulmonary embolism was confirmed by ventilation–perfusion lung scanning, spiral CT, or pulmonary angiography. Major bleeding was defined as fatal bleeding, hemorrhagic stroke, or a drop in the hemoglobin concentration by at least 4 g per deciliter, with or without the need for red-cell transfusion. Hemorrhagic or ischemic stroke was confirmed by CT or magnetic resonance imaging.
Statistical Analysis
The data were analyzed by an independent clinical research organization that also monitored the study (Parexel, Berlin, Germany). All the authors had full access to the data and participated in the data analysis. The null hypothesis was that there would be no difference between the two treatment groups with regard to the primary end point — that is, that the proportion of patients who reached the primary end point (death or the need for an escalation of therapy) would be the same in each group. On the basis of the data provided by the Management Strategies and Prognosis of Pulmonary Embolism Registry,12 it was calculated that 217 patients would be required in each group to reject the null hypothesis with a power of 80 percent and at an alpha level of 5 percent, by the detection of a 33 percent relative reduction (or a 13 percent absolute reduction, from 39 to 26 percent) in the incidence of the primary end point. An interim analysis after the enrollment of the first 250 patients was prospectively planned to verify these calculations. The study was terminated after the interim analysis, which demonstrated a statistically significant difference in favor of alteplase treatment at that point.
Statistical analysis was performed according to the intention-to-treat principle. Differences between the treatment groups were examined with the use of Fisher's exact test (for proportions) and Student's t-test (for means of continuous variables). The time from randomization to death or escalation of treatment was analyzed with the use of the log-rank test, and Kaplan–Meier estimates of the probability of event-free survival were calculated. To define further the prognostic importance of treatment and other base-line variables, a proportional-hazards model was applied to the primary end point. The results are presented as relative risks and corresponding 95 percent confidence intervals. All reported P values are two-sided. Plus–minus values are means ±SD, unless stated otherwise.
Results
Characteristics of the Patients
A total of 256 patients underwent randomization. Of these patients, 118 were assigned to the heparin-plus-alteplase group and 138 to the heparin-plus-placebo group. The two groups were well matched with regard to major clinical characteristics at base line (Table 1Table 1
Base-Line Characteristics of the Study Patients.). There were no significant differences in systolic or diastolic blood pressure, heart rate, or the severity of dyspnea or arterial hypoxemia. Catheterization of the right side of the heart was performed in 43 patients, 19 (16.1 percent) in the heparin-plus-alteplase group and 24 (17.4 percent) in the heparin-plus-placebo group. There were no significant differences between the two treatment groups with regard to pulmonary-artery pressures (systolic: 55.2±14.0 mm Hg in the heparin-plus-alteplase group and 60.42±15.9 mm Hg in the heparin-plus-placebo group; diastolic: 21.9±8.0 and 23.9±8.9 mm Hg, respectively; mean: 34.0±8.5 and 36.1±10.6 mm Hg, respectively).Echocardiography was performed in 106 of the patients assigned to receive heparin plus alteplase (89.8 percent), and 129 of those assigned to receive heparin plus placebo (93.5 percent). The incidence of right ventricular dysfunction was almost identical in the two groups (Table 1). Doppler echocardiography revealed that the mean tricuspid regurgitant jet velocity was elevated in both groups (3.23±0.66 m per second in the heparin-plus-alteplase group, and 3.31±0.78 m per second in the heparin-plus-placebo group).
Clinical Outcome during the In-Hospital Phase
Table 2Table 2
In-Hospital Clinical Events. summarizes in-hospital clinical events in the two study groups. The mean duration of the hospital stay was 16.7±8.4 days (range, 2 to 70). The mortality rate was low in both treatment groups. Four patients in the heparin-plus-alteplase group died, two from pulmonary embolism and two from underlying disease. Three patients in the heparin-plus-placebo group died, two from pulmonary embolism and one from a bleeding complication. Although the mortality rate in the two groups was similar, the rate of escalation of treatment because of clinical deterioration was much higher in the heparin-plus-placebo group than in the heparin-plus-alteplase group. For example, secondary (rescue) thrombolysis was performed roughly three times as often in the heparin-plus-placebo group as in the heparin-plus-alteplase group (Table 2). In the heparin-plus-placebo group, the indications for secondary thrombolysis were cardiogenic shock (in 4 patients), arterial hypotension requiring catecholamine infusion (in 4), and worsening symptoms and respiratory failure (in 24 patients, 3 of whom underwent endotracheal intubation and mechanical ventilation). In the heparin-plus-alteplase group, nine patients underwent additional thrombolysis, one because of arterial hypotension and the remaining eight because of worsening symptoms; one of the latter patients underwent endotracheal intubation). Overall, the incidence of the primary end point (death or escalation of treatment) was significantly greater in the heparin-plus-placebo group than in the heparin-plus-alteplase group (34 patients [24.6 percent] vs. 13 patients [11.0 percent], P=0.006).In accord with these data, the probability of 30-day event-free survival according to Kaplan–Meier analysis was significantly higher in the group of patients treated with heparin plus alteplase than in those treated with heparin plus placebo (P=0.005 by the log-rank test) (Figure 1Figure 1
Kaplan–Meier Estimates of the Probability of Event-free Survival among Patients with Acute Submassive Pulmonary Embolism, According to Treatment with Heparin plus Alteplase or Heparin plus Placebo.). Further analysis with use of the proportional-hazards model confirmed that treatment with heparin plus placebo predicted an unfavorable in-hospital outcome: the relative risk of the primary end point with heparin plus placebo as compared with heparin plus alteplase was 2.63 (P=0.006) (Table 3Table 3
Determinants of the Risk of In-Hospital Death or Escalation of Treatment.). As shown in Figure 2Figure 2Mean Activated Partial-Thromboplastin Time in Patients with Acute Submassive Pulmonary Embolism, According to Treatment with Heparin plus Alteplase or Heparin plus Placebo., the favorable outcome of the patients assigned to heparin plus alteplase was not due to greater effectiveness of heparin anticoagulation in this group than in the other group, since the activated partial-thromboplastin time reached similar levels in the two treatment groups between 12 and 48 hours after randomization. Of the other base-line variables tested in the proportional-hazards model, age older than 70 years, female sex, and the presence of arterial hypoxemia were also found to predict an increased risk of in-hospital death or escalation of treatment (Table 3).Secondary End Points, Safety, and Tolerability
The incidence of recurrent pulmonary embolism was low in both treatment groups (Table 2). However, its incidence may have been underestimated because of the relatively strict criteria for confirmation of recurrent thromboembolic events. Bleeding complications were uncommon, and the incidence of bleeding was not higher in the heparin-plus-alteplase group than in the heparin-plus-placebo group. In particular, there was only one fatal bleeding episode (in the heparin-plus-placebo group), and there were no hemorrhagic strokes. Minor symptoms that may have been related to the study medication were reported in 72 patients in the heparin-plus-alteplase group (61.0 percent) and in 78 patients in the heparin-plus-placebo group (56.5 percent) (P=0.55), but they did not result in discontinuation of treatment or breaking of the randomization code.
Discussion
Previous studies have convincingly demonstrated the ability of thrombolytic agents to dissolve pulmonary emboli and to improve pulmonary perfusion and right ventricular function.14-21 These medications are therefore recommended for the treatment of massive pulmonary embolism. However, the efficacy of thrombolytic agents in the treatment of submassive pulmonary embolism has remained unclear,1 and identifying the patient population in which the benefits of thrombolysis may outweigh the associated risks of bleeding has been the subject of debate, mostly because of the lack of large-scale clinical trials.4 Our study was designed to address these issues directly. Our results indicate that alteplase, given with heparin, improves the clinical course of hemodynamically stable patients who have acute submassive pulmonary embolism and that it does so with a low risk of major hemorrhagic complications.
The clinical course and prognosis of patients with acute pulmonary embolism vary widely, depending on their clinical and hemodynamic status at the time of diagnosis.22-25 In particular, right ventricular dysfunction has been identified as a predictor of adverse outcome.5,10,26 Thus, in the current trial, we focused on patients who presented with evidence of pulmonary hypertension, right ventricular dysfunction, or both of these conditions,27 which were prospectively defined according to strict echocardiographic and hemodynamic criteria.9,12 We excluded patients with persistent arterial hypotension or shock resulting from overt right ventricular failure; the prognosis of such hemodynamically unstable patients with massive pulmonary embolism is so poor10 that withholding thrombolytic therapy (or other aggressive treatment) would be considered unethical, even though there is a lack of large clinical trials to prove its efficacy in these patients.28
In the current study, the patients in the two treatment groups were well matched with regard to base-line characteristics. Kaplan–Meier analysis showed that the probability of event-free survival during the hospital stay was significantly lower in the patients assigned to receive heparin plus placebo than in those assigned to receive heparin plus alteplase. Although the in-hospital mortality rate was similar in the two groups, the incidence of clinical deterioration requiring escalation of treatment was higher in the heparin-plus-placebo group. In particular, secondary thrombolysis (for predefined clinical and hemodynamic indications) was needed three times as often in the patients assigned to heparin plus placebo. Given the strict randomization and blinding used in the trial, it seems unlikely that the higher incidence of secondary thrombolysis in the heparin-plus-placebo group was due to bias on the part of the investigators in favor of thrombolytic therapy. Therefore, it seems reasonable to assume that delayed resolution (or lack of resolution)8,9 or recurrence20 of pulmonary embolism with heparin alone resulted in persistence or deterioration of pulmonary hypertension and right-sided heart failure.29
In-hospital mortality rates were low in our study, and there were no significant differences between the two treatment groups. This finding was unexpected, in view of the results of analysis of the Management Strategies and Prognosis of Pulmonary Embolism registry, which showed a mortality rate of 8 percent among hemodynamically stable patients with right ventricular dysfunction.10 However, patient monitoring is closer and the degree of alertness on the part of caregivers is generally higher in randomized therapeutic trials than in registries, and it is possible that, in the current trial, clinicians' prompt response to early signs of clinical deterioration averted some in-hospital deaths.
Thrombolysis may be associated with a significant increase in the risk of fatal or disabling hemorrhagic complications.7,12,30 However, the rates of bleeding in our patient population were very low, and no patient had intracranial or fatal hemorrhage after treatment with alteplase. Our findings, combined with those of another controlled trial of thrombolysis in pulmonary embolism,20 support the notion that alteplase is a safe treatment for hemodynamically stable patients with acute submassive pulmonary embolism, provided that it is not given to patients with contraindications to thrombolysis and provided that the patients' clinical condition and coagulation status are closely monitored.
In conclusion, the findings of this randomized, double-blind, placebo-controlled trial show that treatment with alteplase, given in conjunction with heparin, may improve the clinical course of patients with acute submassive pulmonary embolism and, in particular, that such treatment may prevent further clinical or hemodynamic deterioration requiring the escalation of treatment during the hospital stay. On the basis of these data, we believe that the indications for thrombolysis, which are currently limited to massive pulmonary embolism, can be extended to include submassive pulmonary embolism (manifested as right ventricular pressure overload and dysfunction) in hemodynamically stable patients. Patients thus treated should be carefully monitored to ensure that they are at low risk for serious bleeding complications.
Supported by Boehringer Ingelheim Pharma (Ingelheim, Germany).
We are indebted to T. Bregenzer (Parexel, Berlin, Germany) for statistical analysis and to R. Sigmund and E. Bluhmki (Boehringer Ingelheim Pharma, Biberach, Germany) for statistical advice.
Source Information
From the Department of Cardiology and Pulmonary Medicine, Georg-August-Universität, Göttingen (S.K.); the Department of Cardiology and Angiology, Albert-Ludwigs-Universität, Freiburg (A.G.); Boehringer Ingelheim Pharma, Ingelheim (G.H.); Krankenhaus Bruchsal, Bruchsal (F.H.); and Department of Internal Medicine, St. Josefs Hospital, Wiesbaden (W.K.) — all in Germany.
Address reprint requests to Dr. Konstantinides at the Department of Cardiology and Pulmonary Medicine, Georg-August-Universität Göttingen, Robert Koch Str. 40, Göttingen, D-37075 Germany, or at skonstan@med.uni-goettingen.de.
The investigators are listed in the Appendix.
Appendix
The following investigators participated in the Management Strategies and Prognosis of Pulmonary Embolism-3 Trial: Steering Committee: W. Kasper, S. Konstantinides, A. Geibel, G. Heusel, E. Bluhmki, F. Heinrich, and K. Rauber; Participating investigators and centers: W. Kasper, St. Josefs Hospital, Wiesbaden; E. Wolff, Kreiskrankenhaus, Demmin; G. Lockert, Krankenhaus Stade, Stade; H. Hoetz, Krankenhaus Ludmillens, Meppen an der Ems; V. Hitz, Ruppiner Kliniken, Neuruppin; W. Rösch and G.C. Cieslinski, Krankenhaus Nordwest, Frankfurt am Main; M. Wiersbitzky, Universitätsklinik, Greifswald; M. Bollhorst, Kreiskrankenhaus, Sinsheim; F. Höltermann, Kreiskrankenhaus, Weinheim; W. Sehnert, Evangelisches Krankenhaus, Herne; J. Lehmann, Krankenhaus vom Deutschen Roten Kreuz, Saarlouis; D. Widmann, Städtisches Krankenhaus, Pfullendorf; E. Kauder, Kreiskrankenhaus, Tuttlingen; K. Schlotterbeck, Kreiskrankenhaus, Traunstein; C. Wonhas, Kreiskrankenhaus, München-Pasing; A. Geibel, Universitätsklinik, Freiburg; H.D. Bundschuh and M. Haag, Caritas Krankenhaus, Bad Mergentheim; R. Thiele, Universitätsklinik, Jena; C. Kelbel, Kreiskrankenhaus, Lüdenscheid; H.J. Simon, Krankenhaus Düren, Düren; G. Krahnstöver, Katharinen Hospital, Willich; U. Fahrenkrog, Klinikum Remscheid, Remscheid; A. Zeiher, Universitätsklinik, Frankfurt am Main; J. Cyran, Städtisches Krankenhaus, Heilbronn; F. Forycki, Krankenhuas Neukölln, Berlin; J. Kohler, Klinikum der Stadt Villingen-Schwenningen, Villingen-Schwenningen; B. Kohler, Krankenhaus Bruchsal, Bruchsal; R. Zahn, Klinikum der Stadt Ludwigshafen, Ludwigshafen; M. Weise and J. Neidermeyer, Universitätsklinik, Dresden; B. Becker, St. Gertrauden Krankenhaus, Berlin; P. Limbourg, Stadtkrankenhaus, Worms; P. Schweitzer, Evangelisches Krankenhaus, Bergisch-Gladbach; H. Ditter, Städtisches Krankenhaus, Gütersloh; K.E. Hauptmann, Krankenhaus der Barmherzigen Brüder, Trier; D.C. Gulba, Virchow Klinikum, Humboldt Universität, Berlin; H. Nebelsieck, Kreiskrankenhaus, Böblingen; W. Dippold, St. Vienzenz und Elisabeth Hospital, Mainz; M. Rejmann, Kreiskrankenhaus, Oberviechtach; M. Bähr, Krankenhaus Speyererhof, Heidelberg; W. Voss, Universitätsklinik, Rostock; E. Altmann, Städtisches Klinikum, Dresden; A. Jöst, Kreiskrankenhaus, Merzig; H. Mehmel, Städtisches Klinikum, Karlsruhe; M.H. Hust, Kreiskrankenhaus, Reutlingen; H. Büttner and G. Müller-Est, Kliniken Konstanz, Konstanz; R. Dissmann, Zentralkrankenhaus Reinkenheide, Bremerhaven; C. Zipp, Krankenhaus Radolfzell, Radolfzell; D. Gerlach, Krankenhaus Bethesda, Stuttgart; and B. Hammer and G. Berg, Universitätsklinik, Homburg an der Saar — all in Germany.
- References
References
1
Dalen JE ,Alpert JS ,Hirsch J . Thrombolytic therapy for pulmonary embolism: is it effective? Is it safe? When is it indicated? Arch Intern Med 1997;157:2550-2556
CrossRef | Web of Science | Medline2
Goldhaber SZ . Thrombolysis in pulmonary embolism: a debatable indication. Thromb Haemost 2001;86:444-451
Web of Science | Medline3
Konstantinides S ,Geibel A ,Kasper W . Submassive and massive pulmonary embolism: a target for thrombolytic therapy? Thromb Haemost 1999;82:Suppl 1:104-108
Medline4
Goldhaber SZ . Thrombolysis in pulmonary embolism: a large-scale clinical trial is overdue. Circulation 2001;104:2876-2878
Web of Science | Medline5
Goldhaber SZ ,Visani L ,De Rosa M . Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353:1386-1389
CrossRef | Web of Science | Medline6
Kanter DS ,Mikkola KM ,Patel SR ,Parker JA ,Goldhaber SZ . Thrombolytic therapy for pulmonary embolism: frequency of intracranial hemorrhage and associated risk factors. Chest 1997;111:1241-1245
CrossRef | Web of Science | Medline7
Hamel E ,Pacouret G ,Vincentelli D , et al. Thrombolysis or heparin therapy in massive pulmonary embolism with right ventricular dilation: results from a 128-patient monocenter registry. Chest 2001;120:120-125
CrossRef | Web of Science | Medline8
Konstantinides S ,Tiede N ,Geibel A ,Olschewski M ,Just H ,Kasper W . Comparison of alteplase versus heparin for resolution of major pulmonary embolism. Am J Cardiol 1998;82:966-970
CrossRef | Web of Science | Medline9
Dalen JE ,Banas JS Jr ,Brooks HL ,Evans GL ,Paraskos JA ,Dexter L . Resolution rate of acute pulmonary embolism in man. N Engl J Med 1969;280:1194-1199
Full Text | Web of Science | Medline10
Kasper W ,Konstantinides S ,Geibel A , et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol 1997;30:1165-1171
CrossRef | Web of Science | Medline11
McIntyre KM ,Sasahara AA . The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. Am J Cardiol 1971;28:288-294
CrossRef | Web of Science | Medline12
Konstantinides S ,Geibel A ,Olschewski M , et al. Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. Circulation 1997;96:882-888
Web of Science | Medline13
Kasper W ,Geibel A ,Tiede N , et al. Distinguishing between acute and subacute massive pulmonary embolism by conventional and Doppler echocardiography. Br Heart J 1993;70:352-356
CrossRef | Web of Science | Medline14
Miller GA ,Sutton GC ,Kerr IH ,Gibson RV ,Honey M . Comparison of streptokinase and heparin in treatment of isolated acute massive pulmonary embolism. Br Heart J 1971;33:616-616
CrossRef | Web of Science | Medline15
The urokinase pulmonary embolism trial: a national cooperative study. Circulation 1973;47:Suppl II:II-1
16
Goldhaber SZ ,Vaughan DE ,Markis JE , et al. Acute pulmonary embolism treated with tissue plasminogen activator. Lancet 1986;2:886-889
CrossRef | Web of Science | Medline17
Goldhaber SZ ,Kessler CM ,Heit J , et al. Randomised controlled trial of recombinant tissue plasminogen activator versus urokinase in the treatment of acute pulmonary embolism. Lancet 1988;2:293-298
CrossRef | Web of Science | Medline18
Dalla-Volta S ,Palla A ,Santolicandro A , et al. PAIMS 2: alteplase combined with heparin versus heparin in the treatment of acute pulmonary embolism: Plasminogen Activator Italian Multicenter Study 2. J Am Coll Cardiol 1992;20:520-526
CrossRef | Web of Science | Medline19
Meyer G ,Sors H ,Charbonnier B , et al. Effects of intravenous urokinase versus alteplase on total pulmonary resistance in acute massive pulmonary embolism: a European multicenter double-blind trial. J Am Coll Cardiol 1992;19:239-245
CrossRef | Web of Science | Medline20
Goldhaber SZ ,Haire WD ,Feldstein ML , et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet 1993;341:507-511
CrossRef | Web of Science | Medline21
Goldhaber SZ ,Kessler CM ,Heit JA , et al. Recombinant tissue-type plasminogen activator versus a novel dosing regimen of urokinase in acute pulmonary embolism: a randomized controlled multicenter trial. J Am Coll Cardiol 1992;20:24-30
CrossRef | Web of Science | Medline22
Gulba DC ,Schmid C ,Borst HG ,Lichtlen P ,Dietz R ,Luft FC . Medical compared with surgical treatment for massive pulmonary embolism. Lancet 1994;343:576-577
CrossRef | Web of Science | Medline23
Carson JL ,Kelley MA ,Duff A , et al. The clinical course of pulmonary embolism. N Engl J Med 1992;326:1240-1245
Full Text | Web of Science | Medline24
Research Committee of the British Thoracic Society
Web of Science | Medline25
Alpert JS ,Smith R ,Carlson J ,Ockene IS ,Dexter L ,Dalen JE . Mortality in patients treated for pulmonary embolism. JAMA 1976;236:1477-1480
CrossRef | Web of Science | Medline26
Kasper W ,Konstantinides S ,Geibel A ,Tiede N ,Krause T ,Just H . Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 1997;77:346-349
Web of Science | Medline27
Goldhaber SZ . Echocardiography in the management of pulmonary embolism. Ann Intern Med 2002;36:691-70028
Jerjes-Sanchez C ,Ramirez-Rivera A ,de Lourdes Garcia M , et al. Streptokinase and heparin versus heparin alone in massive pulmonary embolism: a randomized controlled trial. J Thromb Thrombolysis 1995;2:227-229
Medline29
Sharma GV ,Folland ED ,McIntyre KM ,Sasahara AA . Long-term benefit of thrombolytic therapy in patients with pulmonary embolism. Vasc Med 2000;5:91-95
Web of Science | Medline30
Levine MN . Thrombolytic therapy for venous thromboembolism: complications and contraindications. Clin Chest Med 1995;16:321-328
Web of Science | Medline
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Paul D. Stein, Fadi Matta. (2012) Thrombolytic Therapy in Unstable Patients with Acute Pulmonary Embolism: Saves Lives but Underused. The American Journal of Medicine
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G. Meyer. (2011) Indications du traitement fibrinolytique au cours de l’embolie pulmonaire. Journal des Maladies Vasculaires 36, S33-S36
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Mabrouk Bahloul, Anis Chaari, Najla Ben Algia, Mounir Bouaziz. (2011) Pulmonary embolism in intensive care unit “literature review”. Trends in Anaesthesia and Critical Care
CrossRef7
Jernej Vidmar, Aleš Blinc, Eduard Kralj, Jože Balažic, Franci Bajd, Igor Serša. (2011) An MRI study of the differences in the rate of thrombolysis between red blood cell-rich and platelet-rich components of venous thrombi ex vivo. Journal of Magnetic Resonance Imaging 34:5, 1184-1191
CrossRef8
James M. Hunt, Todd M. Bull. (2011) Clinical Review of Pulmonary Embolism: Diagnosis, Prognosis, and Treatment. Medical Clinics of North America 95:6, 1203-1222
CrossRef9
Paul D. Stein, Fadi Matta, David S. Steinberger, Daniel C. Keyes. (2011) Intracerebral Hemorrhage with Thrombolytic Therapy for Acute Pulmonary Embolism. The American Journal of Medicine
CrossRef10
Timothy A. Morris. (2011) Natural History of Venous Thromboembolism. Critical Care Clinics 27:4, 869-884
CrossRef11
Jean Michel Yeguiayan, Isabelle Benatru, Boris Guiu, Jamal Abou Taam, Serge Albertini, Marc Freysz, Maurice Giroud. (2011) Recombinant tissue plasminogen activator for both pulmonary and cerebral embolism. The American Journal of Emergency Medicine 29:8, 961.e1-961.e4
CrossRef12
Mareike Lankeit, Stavros Konstantinides. (2011) Mortality Risk Assessment and the Role of Thrombolysis in Pulmonary Embolism. Critical Care Clinics 27:4, 953-967
CrossRef13
Jung-Wan Yoo, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh. (2011) Clinical implications of right ventricular dysfunction in patients with acute symptomatic pulmonary embolism: Short- and long-term clinical outcomes. Journal of Critical Care
CrossRef14
Victor F. Tapson. (2011) Treatment of Pulmonary Embolism: Anticoagulation, Thrombolytic Therapy, and Complications of Therapy. Critical Care Clinics 27:4, 825-839
CrossRef15
Hans Scheffel, Paul Stolzmann, Sebastian Leschka, Lotus Desbiolles, Burkhardt Seifert, Borut Marincek, Hatem Alkadhi. (2011) Ventricular short-axis measurements in patients with pulmonary embolism: Effect of ECG-gating on variability, accuracy, and risk prediction. European Journal of Radiology
CrossRef16
S. VANNI, P. NAZERIAN, G. PEPE, M. BAIONI, M. Risso, G. GRIFONI, G. VIVIANI, S. GRIFONI. (2011) Comparison of two prognostic models for acute pulmonary embolism: clinical vs. right ventricular dysfunction-guided approach. Journal of Thrombosis and Haemostasis 9:10, 1916-1923
CrossRef17
T G DeLoughery. (2011) Between scylla and charybdis: antithrombotic therapy in hematopoietic progenitor cell transplant patients. Bone Marrow Transplantation
CrossRef18
Anne-Line Moroni, Jean-Luc Bosson, Noélie Hohn, Françoise Carpentier, Gilles Pernod, Gilbert R. Ferretti. (2011) Non-severe pulmonary embolism: Prognostic CT findings. European Journal of Radiology 79:3, 452-458
CrossRef19
H. Gao, G.-Y. Huang, L.-L. Ma, L.-X. Wang. (2011) Combined catheter thrombus fragmentation and fibrinolysis for acute pulmonary embolism. Internal Medicine Journal 41:9, 687-691
CrossRef20
Tracy Minichiello, Lauren Doctoroff, Elizabeth A. Farrell. 2011. Treatment of Acute Venous Thromboembolism in Hospitalized Patients. , 137-160.
CrossRef21
Mariette J. Agterof, Roger E.G. Schutgens, Noureddine Moumli, M.J.C. Eijkemans, René van der Griend, Ellen A.M. Tromp, Douwe H. Biesma. (2011) A prognostic model for short term adverse events in normotensive patients with pulmonary embolism. American Journal of Hematology 86:8, 646-649
CrossRef22
Doo Kyoung Kang, Christian Thilo, U. Joseph Schoepf, J. Michael Barraza, John W. Nance, Gorka Bastarrika, Joseph A. Abro, James G. Ravenel, Philip Costello, Samuel Z. Goldhaber. (2011) CT Signs of Right Ventricular Dysfunction. JACC: Cardiovascular Imaging 4:8, 841-849
CrossRef23
C. Becattini, G. Agnelli, M. C. Vedovati, P. Pruszczyk, F. Casazza, S. Grifoni, A. Salvi, M. Bianchi, R. Douma, S. Konstantinides, M. Lankeit, M. Duranti. (2011) Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. European Heart Journal 32:13, 1657-1663
CrossRef24
Sergio Fasullo, Sebastiano Scalzo, Giorgio Maringhini, Sergio Cannizzaro, Gabriella Terrazzino, Salvatore Paterna, Pietro Di Pasquale. (2011) Thrombolysis for massive pulmonary embolism in pregnancy: a case report. The American Journal of Emergency Medicine 29:6, 698.e1-698.e4
CrossRef25
Doo Kyoung Kang, Joo Sung Sun, Kyung Joo Park, Hong Seok Lim. (2011) Usefulness of Combined Assessment With Computed Tomographic Signs of Right Ventricular Dysfunction and Cardiac Troponin T for Risk Stratification of Acute Pulmonary Embolism. The American Journal of Cardiology 108:1, 133-140
CrossRef26
Jeong Rang Park, Sung-A Chang, Shin Yi Jang, Hye Jin No, Sung-Ji Park, Seung-Hyuk Choi, Seung Woo Park, Hojoong Kim, Yeon Hyeon Choe, Kyung Soo Lee, Jae K. Oh, Duk-Kyung Kim. (2011) Evaluation of right ventricular dysfunction and prediction of clinical outcomes in acute pulmonary embolism by chest computed tomography: comparisons with echocardiography. The International Journal of Cardiovascular Imaging
CrossRef27
Francis M. Fesmire, Michael D. Brown, James A. Espinosa, Richard D. Shih, Scott M. Silvers, Stephen J. Wolf, Wyatt W. Decker. (2011) Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Suspected Pulmonary Embolism. Annals of Emergency Medicine 57:6, 628-652.e75
CrossRef28
B. Planquette, L. Belmont, Guy Meyer, Olivier Sanchez. (2011) Prise en charge diagnostique et thérapeutique de l’embolie pulmonaire grave. Revue des Maladies Respiratoires 28:6, 778-789
CrossRef29
J. S. Bhuvaneswaran, Rajendra Kumar Premchand, S. S. Iyengar, Rajeev Khare, C. B. Chabra, T. N. C. Padmanabhan, S. K. Sharma, Alkesh Jain, S. A. Pandian, S. Rajdev, N. Modi, V. Kumar. (2011) Tenecteplase in the treatment of acute pulmonary thrombo-embolism. Journal of Thrombosis and Thrombolysis 31:4, 445-448
CrossRef30
Margaret A. Miller, Michel Chalhoub, Ghada Bourjeily. (2011) Peripartum Pulmonary Embolism. Clinics in Chest Medicine 32:1, 147-164
CrossRef31
Pietro Roversi, Mauro Campanini. (2011) BPCO e tromboembolismo venoso. Italian Journal of Medicine 5:1, 57-66
CrossRef32
F. García-Bragado Dalmau. (2011) Embolismo pulmonar agudo: por y para qué estratificar el riesgo. Revista Clínica Española 211:2, 90-91
CrossRef33
Miguel Ángel de Gregorio, Alicia Laborda, Ignacio de Blas, Joaquín Medrano, Antonio Mainar, Mikel Oribe. (2011) Tratamiento endovascular mediante fibrinolisis y fragmentación del embolismo pulmonar masivo con inestabilidad hemodinámica. Experiencia de un solo centro en 111 pacientes. ¿Por qué no seguimos las recomendaciones de la ACCP?. Archivos de Bronconeumología 47:1, 17-24
CrossRef34
Sergio Fasullo, Sebastiano Scalzo, Giorgio Maringhini, Filippo Ganci, Sergio Cannizzaro, Ivana Basile, Debora Cangemi, Gabriella Terrazzino, Gaspare Parrinello, Filippo M. Sarullo, Roberto Baglini, Salvatore Paterna, Pietro Di Pasquale. (2011) Six-Month Echocardiographic Study in Patients With Submassive Pulmonary Embolism and Right Ventricle Dysfunction: Comparison of Thrombolysis With Heparin. The American Journal of the Medical Sciences 341:1, 33-39
CrossRef35
Hyun Ju Seon, Kye Hun Kim, Woo Seok Lee, Song Choi, Hyun Ju Yoon, Youngkeun Ahn, Yun-Hyeon Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang. (2011) Usefulness of Computed Tomographic Pulmonary Angiography in the Risk Stratification of Acute Pulmonary Thromboembolism. Circulation Journal 75:2, 428-436
CrossRef36
Issam D. Moussa. (2011) Percutaneous mechanical thrombectomy in patients with submassive pulmonary embolism. Catheterization and Cardiovascular Interventions 77:1, 148-149
CrossRef37
Ikuo Fukuda, Satoshi Taniguchi. (2011) Embolectomy for acute pulmonary thromboembolism: From Trendelenburg’s procedure to the contemporary surgical approach. Surgery Today 41:1, 1-6
CrossRef38
Sergio Fasullo, Giorgio Maringhini, Gabriella Terrazzino, Filippo Ganci, Salvatore Paterna, Pietro Di Pasquale. (2011) Thrombolysis for massive pulmonary embolism in pregnancy: a case report. International Journal of Emergency Medicine 4:1, 69
CrossRef39
Mareike Lankeit, Stavros Konstantinides. (2010) Mortality Risk Assessment and the Role of Thrombolysis in Pulmonary Embolism. Clinics in Chest Medicine 31:4, 759-769
CrossRef40
Mareike Lankeit, Stavros Konstantinides. (2010) Tenecteplase can be given to patients with intermediate-risk pulmonary embolism – But should it?. Thrombosis Research 126:6, e407-e408
CrossRef41
David Jiménez, Drahomir Aujesky, Roger D. Yusen. (2010) Risk stratification of normotensive patients with acute symptomatic pulmonary embolism. British Journal of Haematology 151:5, 415-424
CrossRef42
Marc A. Rodger, Genevieve Le Templier. 2010. Anticoagulant Therapy During Pregnancy and Gynecology. , 111-152.
CrossRef43
Nicolas Meneveau. (2010) Therapy for acute high-risk pulmonary embolism: thrombolytic therapy and embolectomy. Current Opinion in Cardiology 25:6, 560-567
CrossRef44
Josien van Es, Renée A. Douma, Victor E. A. Gerdes, Pieter W. Kamphuisen, Harry R. Büller. (2010) Acute pulmonary embolism. Part 2: treatment. Nature Reviews Cardiology 7:11, 613-622
CrossRef45
William T. Kuo, Lawrence V. Hofmann. (2010) Drs. Kuo and Hofmann respond. Journal of Vascular and Interventional Radiology 21:11, 1776-1777
CrossRef46
Ana Maestre, Rosario Sánchez, Vladimir Rosa, Drahomir Aujesky, Alicia Lorenzo, Giovanni Barillari, Manuel Monreal. (2010) Clinical characteristics and outcome of inpatients versus outpatients with venous thromboembolism. European Journal of Internal Medicine 21:5, 377-382
CrossRef47
T. M. Berghaus, C. Thilo, A. Bluethgen, W. Scheidt, M. Schwaiblmair. (2010) Effectiveness of thrombolysis in patients with intermediate-risk pulmonary embolism: Influence on length of hospital stay. Advances in Therapy 27:9, 648-654
CrossRef48
Rafael Golpe, Luis A. Pérez-de-Llano, Olalla Castro-Añón, Manuel Vázquez-Caruncho, Carlos González-Juanatey, Alejandro Veres-Racamonde, Concepción Iglesias-Moreira, María Carmen Fariñas. (2010) Right ventricle dysfunction and pulmonary hypertension in hemodynamically stable pulmonary embolism. Respiratory Medicine 104:9, 1370-1376
CrossRef49
Michael Groth, Frank O. Henes, Kai Müllerleile, Gerhard Adam, Philipp G. C. Begemann, Marc Regier. (2010) Correlation of right ventricular dysfunction parameters and pulmonary vascular obstruction score in acute pulmonary embolism in a porcine model. Emergency Radiology 17:5, 367-374
CrossRef50
B. Sareyyupoglu, K. L. Greason, R. M. Suri, M. T. Keegan, J. A. Dearani, T. M. Sundt. (2010) A More Aggressive Approach to Emergency Embolectomy for Acute Pulmonary Embolism. Mayo Clinic Proceedings 85:9, 785-790
CrossRef51
Alessandra Boscheri, Carsten Wunderlich, Martin Langer, Steffen Schoen, Bärbel Wiedemann, Dirk Stolte, Gesa Elmer, Peggy Barthel, Ruth H. Strasser. (2010) Correlation of heart-type fatty acid–binding protein with mortality and echocardiographic data in patients with pulmonary embolism at intermediate risk. American Heart Journal 160:2, 294-300
CrossRef52
S.M. Schellong. (2010) Der intensivpflichtige Patient mit Lungenembolie oder arteriellem Gefäßnotfall. Der Internist 51:8, 995-1002
CrossRef53
M. Lankeit, D. Friesen, J. Aschoff, C. Dellas, G. Hasenfuss, H. Katus, S. Konstantinides, E. Giannitsis. (2010) Highly sensitive troponin T assay in normotensive patients with acute pulmonary embolism. European Heart Journal 31:15, 1836-1844
CrossRef54
V. M. Jha, J. Lee-Llacer, J. Williams, H. Ubaissi, G. Gutierrez. (2010) Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism. CardioVascular and Interventional Radiology 33:4, 739-743
CrossRef55
Agnelli, Giancarlo, Becattini, Cecilia, . (2010) Acute Pulmonary Embolism. New England Journal of Medicine 363:3, 266-274
Full Text56
Adam Torbicki. (2010) Enfermedad tromboembólica pulmonar. Manejo clínico de la enfermedad aguda y crónica. Revista Española de Cardiología 63:7, 832-849
CrossRef57
Aran Singanayagam, James D. Chalmers, Caroline Scally, Ahsan R. Akram, Mudher Z. Al-Khairalla, Leah Leitch, Louise E. Hill, Adam T. Hill. (2010) Right ventricular dilation on CT pulmonary angiogram independently predicts mortality in pulmonary embolism. Respiratory Medicine 104:7, 1057-1062
CrossRef58
Licheng Lee, Clifford J Kavinsky, Christian Spies. (2010) Massive pulmonary embolism: review of management strategies with a focus on catheter-based techniques. Expert Review of Cardiovascular Therapy 8:6, 863-873
CrossRef59
Thomas G. DeLoughery. (2010) Venous Thrombotic Emergencies. Hematology/Oncology Clinics of North America 24:3, 487-500
CrossRef60
Jeffrey F. Barletta, Brad Cooper, Martin J. Ohlinger. (2010) Adverse drug events associated with disorders of coagulation. Critical Care Medicine 38, S198-S218
CrossRef61
Riikka Rydman, Flemming Larsen, Kenneth Caidahl, Mahbubul Alam. (2010) Right Ventricular Function in Patients With Pulmonary Embolism: Early and Late Findings Using Doppler Tissue Imaging. Journal of the American Society of Echocardiography 23:5, 531-537
CrossRef62
Michael B. Streiff. (2010) The National Comprehensive Cancer Center Network (NCCN) guidelines on the management of venous thromboembolism in cancer patients. Thrombosis Research 125, S128-S133
CrossRef63
Charles Y. Kim, Paul V. Suhocki, Michael J. Miller, Mazhar Khan, Gemini Janus, Tony P. Smith. (2010) Provocative Mesenteric Angiography for Lower Gastrointestinal Hemorrhage: Results from a Single-institution Study. Journal of Vascular and Interventional Radiology 21:4, 477-483
CrossRef64
Cecilia Becattini, Giancarlo Agnelli, Aldo Salvi, Stefano Grifoni, Leonardo Goffredo Pancaldi, Iolanda Enea, Franco Balsemin, Mauro Campanini, Angelo Ghirarduzzi, Franco Casazza. (2010) Bolus tenecteplase for right ventricle dysfunction in hemodynamically stable patients with pulmonary embolism. Thrombosis Research 125:3, e82-e86
CrossRef65
Thomas M. Todoran, Piotr Sobieszczyk. (2010) Catheter-Based Therapies for Massive Pulmonary Embolism. Progress in Cardiovascular Diseases 52:5, 429-437
CrossRef66
Ghada Bourjeily, Michael Paidas, Hanan Khalil, Karen Rosene-Montella, Marc Rodger. (2010) Pulmonary embolism in pregnancy. The Lancet 375:9713, 500-512
CrossRef67
Phillips Perera, Thomas Mailhot, David Riley, Diku Mandavia. (2010) The RUSH Exam: Rapid Ultrasound in SHock in the Evaluation of the Critically lll. Emergency Medicine Clinics of North America 28:1, 29-56
CrossRef68
Hyeon Min Ryu, Ju Hwan Lee, Yong Seop Kwon, Sang Hyuk Lee, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae, Jae-Eun Jun, Wee-Hyun Park. (2010) Electrocardiography Patterns and the Role of the Electrocardiography Score for Risk Stratification in Acute Pulmonary Embolism. Korean Circulation Journal 40:10, 499
CrossRef69
Farouk Mookadam, Panupong Jiamsripong, Ramil Goel, Tahlil A. Warsame, Usha R. Emani, Bijoy K. Khandheria. (2010) Critical Appraisal on the Utility of Echocardiography in the Management of Acute Pulmonary Embolism. Cardiology in Review 18:1, 29-37
CrossRef70
Filip Banovac, Donna C. Buckley, William T. Kuo, Denver Matthew Lough, Louis G. Martin, Steven F. Millward, Timothy W.I. Clark, Sanjoy Kundu, Dheeraj K. Rajan, David Sacks, John F. Cardella. (2010) Reporting Standards for Endovascular Treatment of Pulmonary Embolism. Journal of Vascular and Interventional Radiology 21:1, 44-53
CrossRef71
Jernej Vidmar, Aleš Blinc, Igor Serša. (2010) A comparison of the ADC and T 2 mapping in an assessment of blood-clot lysability. NMR in Biomedicine 23:1, 34-40
CrossRef72
Dabit Arzamendi, Luc Bilodeau, Reda Ibrahim, Stephane Noble, Richard Gallo, Philippe Lavoie-L’Allier, Gilbert Gosselin, Pierre Deguise, Hung Ly, Jean-François Tanguay, Serge Doucet. (2010) Role of rheolytic thrombectomy in massive pulmonary embolism with contraindication to systemic thrombolytic therapy. EuroIntervention 5:6, 716-721
CrossRef73
Jae Chol Yoon, Won Young Kim, Sang Sik Choi, Sang Ku Jung, Chang Hwan Sohn, Won Kim, Kyoung Soo Lim, Tae O Jeong, Young Ho Jin, Jae Baek Lee. (2010) D-dimer as a Prognostic Tool in Patients with Normotensive Pulmonary Embolism. Tuberculosis and Respiratory Diseases 68:2, 87
CrossRef74
Walter Ageno. (2010) Recent advances in the management of venous thromboembolism. The Korean Journal of Hematology 45:1, 8
CrossRef75
Joshua Broder. 2010. “Therapeutic Imaging”: Image-Guided Therapies in Emergency Medicine. , e1-e35.
CrossRef76
Mareike Lankeit, Stavros Konstantinides. (2009) Thrombolysis for hemodynamically stable patients with pulmonary embolism: Still searching for the intermediate-risk group. Thrombosis Research 124:6, 647-648
CrossRef77
B. Tardy, C. Venet, F. Zeni, M. Coudrot, S. Guyomarc'h, P. Mismetti. (2009) Short term effect of recombinant tissue plasminogen activator in patients with hemodynamically stable acute pulmonary embolism: Results of a meta-analysis involving 464 patients. Thrombosis Research 124:6, 672-677
CrossRef78
H. Worth. (2009) Aktuelles Management der akuten Lungenembolie. Der Pneumologe 6:6, 378-389
CrossRef79
Farouk Mookadam, Martina Mookadam, Panupong Jiamsripong, Ramil Goel. (2009) Pulmonary thromboembolic disease spectrum: diagnostic and therapeutic strategies. Expert Review of Cardiovascular Therapy 7:11, 1421-1428
CrossRef80
J. L. LOBO, V. ZORRILLA, F. AIZPURU, E. GRAU, D. JIMÃNEZ, G. PALARETI, M. MONREAL, . (2009) D-dimer levels and 15-day outcome in acute pulmonary embolism. Findings from the RIETE Registry. Journal of Thrombosis and Haemostasis 7:11, 1795-1801
CrossRef81
Aaron B. Holley, Joseph G. Cheatham, Jeffrey L. Jackson, Lisa K. Moores, Todd C. Villines. (2009) Novel quantitative echocardiographic parameters in acute PE. Journal of Thrombosis and Thrombolysis 28:4, 506-512
CrossRef82
Sebastien Janin, Nicolas Meneveau, Ailiman Mahemuti, Vincent Descotes-Genon, Joanna Dutheil, Romain Chopard, Marie-France Seronde, Francois Schiele, Yvette Bernard, Jean-Pierre Bassand. (2009) Safety and efficacy of fondaparinux as an adjunctive treatment to thrombolysis in patients with high and intermediate risk pulmonary embolism. Journal of Thrombosis and Thrombolysis 28:3, 320-324
CrossRef83
Thomas G. DeLoughery. (2009) Venous Thrombotic Emergencies. Emergency Medicine Clinics of North America 27:3, 445-458
CrossRef84
S. Konstantinides, U. Janssens, E. Mayer, G. Hasenfuß. (2009) Kommentar zu den ESC-Leitlinien „Guidelines on Diagnosis and Management of Acute Pulmonary Embolism“. Der Kardiologe 3:4, 272-282
CrossRef85
Bi Rong Dong, Qiukui Hao, Jirong Yue, Taixiang Wu, Guan Jian Liu, Bi Rong Dong. 2009. Thrombolytic therapy for pulmonary embolism. .
CrossRef86
S. Z. GOLDHABER. (2009) Advanced treatment strategies for acute pulmonary embolism, including thrombolysis and embolectomy. Journal of Thrombosis and Haemostasis 7, 322-327
CrossRef87
LARS-OLOF HATTENBACH, CARL FRIEDRICH ARNDT, RALF LERCHE, INGE SCHARRER, HOLGER BAATZ, FABRICE MARGARON, GISBERT RICHARD, WOLFGANG BEHRENS-BAUMANN, CHRISTIAN OHRLOFF. (2009) RETINAL VEIN OCCLUSION AND LOW-DOSE FIBRINOLYTIC THERAPY (R.O.L.F.). Retina 29:7, 932-940
CrossRef88
D. AUJESKY, R. HUGHES, D. JIMÉNEZ. (2009) Short-term prognosis of pulmonary embolism. Journal of Thrombosis and Haemostasis 7, 318-321
CrossRef89
Suresh Vedantham, Patricia E. Thorpe, John F. Cardella, Clement J. Grassi, Nilesh H. Patel, Hector Ferral, Lawrence V. Hofmann, Bertrand M. Janne d'Othée, Vittorio P. Antonaci, Elias N. Brountzos. (2009) Quality Improvement Guidelines for the Treatment of Lower Extremity Deep Vein Thrombosis with Use of Endovascular Thrombus Removal. Journal of Vascular and Interventional Radiology 20:7, S227-S239
CrossRef90
Felix Post, Dirk Mertens, Christoph Sinning, Dirk Peetz, Thomas Münzel. (2009) Decision for aggressive therapy in acute pulmonary embolism: implication of elevated troponin T. Clinical Research in Cardiology 98:6, 401-408
CrossRef91
Gregory Piazza, Samuel Z. Goldhaber. 2009. Thrombolysis for Acute Pulmonary Embolism. , 595-616.
CrossRef92
C. BOVA, R. PESAVENTO, A. MARCHIORI, A. PALLA, I. ENEA, V. PENGO, A. VISONÀ, A. NOTO, P. PRANDONI, . (2009) Risk stratification and outcomes in hemodynamically stable patients with acute pulmonary embolism: a prospective, multicentre, cohort study with three months of follow-up. Journal of Thrombosis and Haemostasis 7:6, 938-944
CrossRef93
Stephen M. Pastores. (2009) Management of venous thromboembolism in the intensive care unit. Journal of Critical Care 24:2, 185-191
CrossRef94
Maja Pakiz, Igor But. (2009) Management of acute deep vein thrombosis due to enlarged symptomatic uterine fibroids. International Journal of Gynecology & Obstetrics 105:2, 177-178
CrossRef95
G. Doreen te Raa, Lucie S.M. Ribbert, Repke J. Snijder, Douwe H. Biesma. (2009) Treatment options in massive pulmonary embolism during pregnancy; A case-report and review of literature. Thrombosis Research 124:1, 1-5
CrossRef96
Gregg J. Stashenko, Charles W. Hargett, Victor F. Tapson. (2009) Thrombolytic therapy for venous thromboembolism: Current clinical practice. Journal of Hospital Medicine 4:5, 313-316
CrossRef97
Simone Vanni, Gianluca Polidori, Ruben Vergara, Giuseppe Pepe, Peiman Nazerian, Federico Moroni, Emanuele Garbelli, Fabio Daviddi, Stefano Grifoni. (2009) Prognostic Value of ECG Among Patients with Acute Pulmonary Embolism and Normal Blood Pressure. The American Journal of Medicine 122:3, 257-264
CrossRef98
Tania Chechi, Sabine Vecchio, Gaia Spaziani, Gabriele Giuliani, Federica Giannotti, Chiara Arcangeli, Andrea Rubboli, Massimo Margheri. (2009) Rheolytic thrombectomy in patients with massive and submassive acute pulmonary embolism. Catheterization and Cardiovascular Interventions 73:4, 506-513
CrossRef99
Rudolf A. Weiner, Markos Daskalakis, Sophia Theodoridou, Sven Fassbender, Karin Parutsch. (2009) Systemic thrombolysis for acute massive pulmonary embolism in the immediate postoperative period after bariatric surgery. Surgery for Obesity and Related Diseases 5:2, 271-274
CrossRef100
John H. Reid, Emmanuel E. Coche, Tomio Inoue, Edmund E. Kim, Maurizio Dondi, Naoyuki Watanabe, Giuliano Mariani, . (2009) Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT. European Journal of Nuclear Medicine and Molecular Imaging 36:3, 505-521
CrossRef101
Carlos Jerjes-Sánchez, Sergio Villarreal-Umaña, Alicia Ramírez-Rivera, Anabel Garcia-Sosa, Luis Miguel-Canseco, Tamara Archondo, Esteban Reyes, Angel Garza, Roberto Arriaga, Francisco Castillo, Omar Jasso, Hector Garcia, Martha Bermudez, Jose Maria Hernandez, Jorge Garcia, Pedro Martinez, Francisco Rangel, Jorge Gutierrez, Alfredo Comparan-Nuñez. (2009) Improving adjunctive treatment in pulmonary embolism and fibrinolytic therapy. The role of enoxaparin and weight-adjusted unfractionated heparin. Journal of Thrombosis and Thrombolysis 27:2, 154-162
CrossRef102
Annette Geibel, Christoph Bode, Stavros Konstantinides. (2009) Risikostratifikation und differenzierte Therapiekonzepte auf der Intensivstation bei Patienten mit akuter Lungenembolie. Intensivmedizin und Notfallmedizin 46:1, 14-22
CrossRef103
J. Kjaergaard, B. K. Schaadt, J. O. Lund, C. Hassager. (2009) Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism. European Journal of Echocardiography 10:1, 89-95
CrossRef104
Brian T. Fengler, William J. Brady. (2009) Fibrinolytic therapy in pulmonary embolism: an evidence-based treatment algorithm. The American Journal of Emergency Medicine 27:1, 84-95
CrossRef105
Konstantinides, Stavros, . (2008) Acute Pulmonary Embolism. New England Journal of Medicine 359:26, 2804-2813
Full Text106
Thomas W. Wakefield, Joseph Caprini, Anthony J. Comerota. (2008) Thromboembolic Diseases. Current Problems in Surgery 45:12, 844-899
CrossRef107
Roham T Zamanian, Michael K Gould. (2008) Effectiveness and cost effectiveness of thrombolysis in patients with acute pulmonary embolism. Current Opinion in Internal Medicine 7:6, 638-642
CrossRef108
Ling Zhu, Chen Wang, Yuanhua Yang, Yafeng Wu, Zhenguo Zhai, Huaping Dai, Baosen Pang, Zhaohui Tong. (2008) Value of transthoracic echocardiography in therapy regimens evaluation in pulmonary embolism. Journal of Thrombosis and Thrombolysis 26:3, 251-256
CrossRef109
(2008) Guías de práctica clínica sobre diagnóstico y manejo del tromboembolismo pulmonar agudo. Revista Española de Cardiología 61:12, 1330.e1-1330.e52
CrossRef110
Jaime Lora-Tamayo, Oriol Gasch, Antoni Riera-Mestre, Francesc Formiga, Ramón Pujol. (2008) THROMBOLYSIS IN ELDERLY PATIENTS WITH MASSIVE PULMONARY EMBOLISM. Journal of the American Geriatrics Society 56:10, 1964-1966
CrossRef111
Tina T. Biss, Leonardo R. Brandão, Walter H. Kahr, Anthony K. Chan, Suzan Williams. (2008) Clinical features and outcome of pulmonary embolism in children. British Journal of Haematology 142:5, 808-818
CrossRef112
Roham T Zamanian, Michael K Gould. (2008) Effectiveness and cost effectiveness of thrombolysis in patients with acute pulmonary embolism. Current Opinion in Pulmonary Medicine 14:5, 422-426
CrossRef113
Syed Wamique Yusuf, Iyad N Daher. (2008) Thrombolytics for PE and right ventricular dysfunction. The Lancet 372:9637, 447
CrossRef114
Karen E. A. Burns, Andrew McLaren. (2008) A critical review of thromboembolic complications associated with central venous catheters. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 55:8, 532-541
CrossRef115
Ling Zhu, Yuanhua Yang, Yafeng Wu, Zhenguo Zhai, Chen Wang. (2008) Value of right ventricular dysfunction for prognosis in pulmonary embolism. International Journal of Cardiology 127:1, 40-45
CrossRef116
J. Kjaergaard, B. K. Schaadt, J. O. Lund, C. Hassager. (2008) Quantification of right ventricular function in acute pulmonary embolism: relation to extent of pulmonary perfusion defects. European Journal of Echocardiography 9:5, 641-645
CrossRef117
Peter Spiegler. (2008) RV Enlargement in Pulmonary Embolism. Clinical Pulmonary Medicine 15:3, 182-183
CrossRef118
Ehab M. Kamel, Sabine Schmidt, Francesco Doenz, Ghazal Adler-Etechami, Pierre Schnyder, Salah D. Qanadli. (2008) Computed Tomographic Angiography in Acute Pulmonary Embolism. Journal of Computer Assisted Tomography 32:3, 438-443
CrossRef119
, A. Torbicki, A. Perrier, S. Konstantinides, G. Agnelli, N. Galie, P. Pruszczyk, F. Bengel, A. J.B. Brady, D. Ferreira, U. Janssens, W. Klepetko, E. Mayer, M. Remy-Jardin, J.-P. Bassand, , A. Vahanian, J. Camm, R. De Caterina, V. Dean, K. Dickstein, G. Filippatos, C. Funck-Brentano, I. Hellemans, S. D. Kristensen, K. McGregor, U. Sechtem, S. Silber, M. Tendera, P. Widimsky, J. L. Zamorano, , J.-L. Zamorano, F. Andreotti, M. Ascherman, G. Athanassopoulos, J. De Sutter, D. Fitzmaurice, T. Forster, M. Heras, G. Jondeau, K. Kjeldsen, J. Knuuti, I. Lang, M. Lenzen, J. Lopez-Sendon, P. Nihoyannopoulos, L. Perez Isla, U. Schwehr, L. Torraca, J.-L. Vachiery. (2008) 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). European Heart Journal 29:18, 2276-2315
CrossRef120
Tapson, Victor F., . (2008) Acute Pulmonary Embolism. New England Journal of Medicine 358:10, 1037-1052
Full Text121
José A. Nieto, María D. Ruiz-Ribó. (2008) Tromboembolia pulmonar. Luces y sombras. Revista Española de Cardiología 61:3, 229-232
CrossRef122
Carlos Escobar, David Jiménez, David Martí, José Luis Lobo, Gema Díaz, Paloma Gallego, Rafael Vidal, Vivencio Barrios, Antonio Sueiro. (2008) Valor pronóstico de los hallazgos electrocardiográficos en pacientes estables hemodinámicamente con tromboembolia de pulmón aguda sintomática. Revista Española de Cardiología 61:3, 244-250
CrossRef123
Tracy Minichiello, Patrick F. Fogarty. (2008) Diagnosis and Management of Venous Thromboembolism. Medical Clinics of North America 92:2, 443-465
CrossRef124
Abbas Chamsuddin, Lama Nazzal, Brandon Kang, Irwin Best, Gail Peters, Sepehr Panah, Louis Martin, Curtis Lewis, Chadi Zeinati, John W. Ho, Anthony C. Venbrux. (2008) Catheter-directed Thrombolysis with the Endowave System in the Treatment of Acute Massive Pulmonary Embolism: A Retrospective Multicenter Case Series. Journal of Vascular and Interventional Radiology 19:3, 372-376
CrossRef125
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Rosenberg, Eric S., Cort, Alice M., Ebeling, Sally H.Peters, Christine C., Kinane, T. Bernard, Grabowski, Eric F., Sharma, Amita, Nimkin, Katherine, King, Mary Etta, Cornell, Lynn D., . (2008) Case 7-2008. New England Journal of Medicine 358:9, 941-952
Full Text126
Samuel Delerme, Patrick Ray. (2008) Cardiac troponin and risk stratification in pulmonary embolism. The American Journal of Emergency Medicine 26:2, 235-236
CrossRef127
Paul D. Stein. 2008. Acute Pulmonary Embolism in the Elderly. , 731-748.
CrossRef128
Christian Fellowes, Caroline Daly, Sonya V. Babu-Narayan, Jonathan Lyne, Julian Collinson. (2008) Portentous pinball. Canadian Journal of Cardiology 24:2, e3-e5
CrossRef129
2008. Respiratory Failure. , 50-73.
CrossRef130
H. Olschewski. (2008) Lungenembolie. Der Pneumologe 5:1, 45-54
CrossRef131
Michael P. Gruber, Todd M. Bull. 2008. Pulmonary Embolism. , 763-781.
CrossRef132
Manabu SAKURAI, Mizuho IMAMAKI, Atsushi ISHIDA, Masaru MIYAZAKI. (2008) ACUTE PULMONARY EMBOLISM FOLLOWING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING. Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 69:1, 34-37
CrossRef133
M.S. Levy, F. Spencer, J.S. Ginsberg, J.A.M. Anderson. (2008) Reading between the (Guidelines). Management of submassive pulmonary embolism in the first trimester of pregnancy. Thrombosis Research 121:5, 705-707
CrossRef134
Paul D. Stein, Afzal Beemath, Fadi Matta, Lawrence R. Goodman, John G. Weg, Charles A. Hales, Russell D. Hull, Kenneth V. Leeper, H. Dirk Sostman, Pamela K. Woodard. (2008) Enlarged Right Ventricle Without Shock in Acute Pulmonary Embolism: Prognosis. The American Journal of Medicine 121:1, 34-42
CrossRef135
A. Vieillard-Baron, P. Vignon. 2008. Chocs obstructifs. , 115-135.
CrossRef136
M. Gómez Antúnez, A. Muiño Míguez, C. Cuenca Carvajal, C. López González-Cobos. (2007) Tromboembolismo pulmonar. Medicine - Programa de Formación Médica Continuada Acreditado 9:90, 5780-5786
CrossRef137
Melvyn Rubenfire, Melike Bayram, Zachary Hector-Word. (2007) Pulmonary Hypertension in the Critical Care Setting: Classification, Pathophysiology, Diagnosis, and Management. Critical Care Clinics 23:4, 801-834
CrossRef138
David Jiménez, Carlos Escobar, David Martí, Gema Díaz, Rafael Vidal, Dolores Taboada, Javier Ortega, José Luis Moya, Vicencio Barrios, Antonio Sueiro. (2007) Valor pronóstico de la ecocardiografía transtorácica en pacientes estables hemodinámicamente con tromboembolia de pulmón aguda sintomática. Archivos de Bronconeumología 43:9, 490-494
CrossRef139
Andrew Worster, Camala Smith, Shawna Silver, Michael D. Brown. (2007) Thrombolytic Therapy for Submassive Pulmonary Embolism?. Annals of Emergency Medicine 50:1, 78-84
CrossRef140
I Serša, J Vidmar, B Grobelnik, U Mikac, G Tratar, A Blinc. (2007) Modelling the effect of laminar axially directed blood flow on the dissolution of non-occlusive blood clots. Physics in Medicine and Biology 52:11, 2969-2985
CrossRef141
C. Becattini, G. Agnelli. (2007) Acute pulmonary embolism: risk stratification in the emergency department. Internal and Emergency Medicine 2:2, 119-129
CrossRef142
Simon J McRae, John W Eikelboom. (2007) Latest medical treatment strategies for venous thromboembolism. Expert Opinion on Pharmacotherapy 8:9, 1221-1233
CrossRef143
Sei Komatsu, Tomokazu Murakawa, Yuichi Sato, Stephan Achenbach, Yutaka Koshimune, Yasuo Fujisawa, Masanori Ando, Yoshiki Nishida, Werner G. Daniel, Atsushi Hirayama, Kazuhisa Kodama. (2007) Rapid successful treatment for massive pulmonary thromboembolism by intravenous thrombolysis: Depiction at multislice computed tomography. International Journal of Cardiology 119:1, e11-e13
CrossRef144
Suzanne Q. van Veen, Joost C.M. Meijers, Marcel Levi, Thomas M. van Gulik, Marja A. Boermeester. (2007) EFFECTS OF INTRA-ABDOMINAL ADMINISTRATION OF RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR ON COAGULATION, FIBRINOLYSIS AND INFLAMMATORY RESPONSES IN EXPERIMENTAL POLYMICROBIAL PERITONITIS. Shock 27:5, 534-541
CrossRef145
R. Agarwal, A. N. Aggarwal, D. Gupta. (2007) Is right heart thromboemboli another indication for thrombolysis?. Internal Medicine Journal 37:5, 333-335
CrossRef146
Jeffrey A. Kline, Jackeline Hernandez-Nino, Alan E. Jones. (2007) Tenecteplase to treat pulmonary embolism in the emergency department. Journal of Thrombosis and Thrombolysis 23:2, 101-105
CrossRef147
Damien Logeart, Lucien Lecuyer, Gabriel Thabut, Jean-Yves Tabet, Jean-Michel Tartière, Christophe Chavelas, François Bonnin, Jean-Louis Stievenart, Alain Cohen Solal. (2007) Biomarker-based strategy for screening right ventricular dysfunction in patients with non-massive pulmonary embolism. Intensive Care Medicine 33:2, 286-292
CrossRef148
H. Worth. (2007) Gerinnungshemmende Therapie der Lungenembolie. Der Pneumologe 4:1, 24-29
CrossRef149
Kayoko TSUCHIDA, Masako OKADA, Takao MAKINO, Naomi UCHIYAMA, Shiho MINETA, Atsushi TAMADA, Yasumi IGARASHI, Hiroyuki FUKUDA, Noriyosi KATO, Taisei MIKAMI. (2007) A case of pulmonary embolism with thrombus trapped across foramen ovale. Choonpa Igaku 34:3, 349-354
CrossRef150
(2007) Invited Synopses. Acute Cardiac Care 9:3, 134-174
CrossRef151
Margaret Wilsher, Henry Connell. 2007. Massive Pulmonary Embolism. , 365-373.
CrossRef152
Samuel Z. Goldhaber. 2007. Deep Vein Thrombosis and Pulmonary Embolism. , 245-256.
CrossRef153
Gregory Piazza, Samuel Z. Goldhaber. (2006) Venous Thromboembolism Guidebook. Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine 5:4, 211-227
CrossRef154
William E Dager, Cynthia A Sanoski, Barbara S Wiggins, James E Tisdale. (2006) Pharmacotherapy Considerations in Advanced Cardiac Life Support. Pharmacotherapy 26:12, 1703-1729
CrossRef155
Jeffrey A. Kline, Jackeline Hernandez-Nino, Geoffrey A. Rose, H James Norton, Carlos A. Camargo. (2006) Surrogate markers for adverse outcomes in normotensive patients with pulmonary embolism*. Critical Care Medicine 34:11, 2773-2780
CrossRef156
2006. Hypertension. .
CrossRef157
David Mountain. (2006) Multislice computed tomographic pulmonary angiography for diagnosing pulmonary embolism in the emergency department: Has the 'one-stop shop' arrived?. Emergency Medicine Australasia 18:5-6, 444-450
CrossRef158
Farzaneh-Far, Ramin, Schwarzberg, Talya, Mushlin, Stuart B., . (2006) Thinking outside the Box. New England Journal of Medicine 354:22, 2376-2381
Full Text159
Philippe de Moerloose, Charles Marc Samama, Serge Motte. (2006) Management of venous thromboembolism. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 53:S2, S80-S88
CrossRef160
Georg Leonhardt, Charly Gaul, Hubert H Nietsch, Michael Buerke, Ekkehard Schleussner. (2006) Thrombolytic therapy in pregnancy. Journal of Thrombosis and Thrombolysis 21:3, 271-276
CrossRef161
Bi Rong Dong, Jirong Yue, Guan Jian Liu, Qin Wang, Taixiang Wu, Bi Rong Dong. 2006. Thrombolytic therapy for pulmonary embolism. .
CrossRef162
Y WEIL, Y MATTAN, V GOLDMAN, M LIEBERGALL. (2006) Sciatic Nerve Palsy Due to Hematoma After Thrombolysis Therapy for Acute Pulmonary Embolism After Total Hip Arthroplasty. The Journal of Arthroplasty 21:3, 456-459
CrossRef163
M. Schmidt, C. Herholz, G. Bodman, M. Block. (2006) Zentrale Lungenembolie mit Rechtsherzthromben bei 60-jährigem Patienten mit nur geringer Belastungsdyspnoe. Intensivmedizin und Notfallmedizin 43:2, 130-133
CrossRef164
Douglas Jackson, Andrei Botea, Yuriy Gubenko, Ellise Delphin, Henry Bennett. (2006) Successful Intraoperative Use of Recombinant Tissue Plasminogen Activator During Liver Transplantation Complicated by Massive Intracardiac/Pulmonary Thrombosis. Anesthesia & Analgesia 102:3, 724-728
CrossRef165
Suresh Vedantham, Patricia E. Thorpe, John F. Cardella, Clement J. Grassi, Nilesh H. Patel, Hector Ferral, Lawrence V. Hofmann, Bertrand M. Janne d'Othée, Vittorio P. Antonaci, Elias N. Brountzos. (2006) Quality Improvement Guidelines for the Treatment of Lower Extremity Deep Vein Thrombosis with Use of Endovascular Thrombus Removal. Journal of Vascular and Interventional Radiology 17:3, 435-448
CrossRef166
John A. Heit. (2006) The Epidemiology of Venous Thromboembolism in the Community: Implications for Prevention and Management. Journal of Thrombosis and Thrombolysis 21:1, 23-29
CrossRef167
Johann Motsch, Andreas Walther, Matthias Bock, Bernd W. B??ttiger. (2006) Update in the prevention and treatment of deep vein thrombosis and pulmonary embolism. Current Opinion in Anaesthesiology 19:1, 52-58
CrossRef168
Brendan P. Madden, Abhijat Sheth, Timothy B.L. Ho. (2006) Thrombolytic therapy for acute proximal pulmonary embolism without significant haemodynamic compromise. Respiratory Medicine Extra 2:1, 34-38
CrossRef169
C. Heleen Van Ommen, Marjolein Peters. (2006) Acute pulmonary embolism in childhood. Thrombosis Research 118:1, 13-25
CrossRef170
Tim S. Bracey, Chris Langrish, Mike Darby, Jasmeet Soar. (2006) Cerebral infarction following thrombolysis for massive pulmonary embolism. Resuscitation 68:1, 135-137
CrossRef171
C. Delasara, E. Boyez, J. Sicot, P. Capelle. (2005) Embolie pulmonaire massive : thrombolyse pré-hospitalière de sauvetage par ténectéplase. Journal Européen des Urgences 18:4, 214-216
CrossRef172
David Garcia, Walter Ageno, Edward Libby. (2005) Update on the diagnosis and management of pulmonary embolism. British Journal of Haematology 131:3, 301-312
CrossRef173
Stavros Konstantinides. (2005) Pulmonary embolism: impact of right ventricular dysfunction. Current Opinion in Cardiology 20:6, 496-501
CrossRef174
David G. Kiely, Norman S. Kennedy, Omar Pirzada, Sheila A. Batchelor, Allan D. Struthers, Brian J. Lipworth. (2005) Elevated levels of natriuretic peptides in patients with pulmonary thromboembolism. Respiratory Medicine 99:10, 1286-1291
CrossRef175
Daniel F. Niendorff, Athos J. Rassias, Robert Palac, Michael L. Beach, Salvatore Costa, Mark Greenberg. (2005) Rapid cardiac ultrasound of inpatients suffering PEA arrest performed by nonexpert sonographers. Resuscitation 67:1, 81-87
CrossRef176
Phua Jason, Lim Tow Keang, Lee Kang Hoe. (2005) B-type natriuretic peptide: Issues for the intensivist and pulmonologist. Critical Care Medicine 33:9, 2094-2013
CrossRef177
J. A. HEIT. (2005) Venous thromboembolism: disease burden, outcomes and risk factors. Journal of Thrombosis and Haemostasis 3:8, 1611-1617
CrossRef178
Emmanuel Coche, Alain Vlassenbroek, Véronique Roelants, William D’Hoore, Franck Verschuren, Louis Goncette, Baudouin Maldague. (2005) Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography. European Radiology 15:7, 1432-1440
CrossRef179
F. Spöhr, B. W. Böttiger, A. Walther. (2005) Fehler und Gefahren der perioperativen Lysetherapie. Der Anaesthesist 54:5, 485-494
CrossRef180
D KESSEL, J PATEL. (2005) Current trends in thrombolysis: implications for diagnostic and interventional radiology. Clinical Radiology 60:4, 413-424
CrossRef181
J. D. DOUKETIS, O. LEEUWENKAMP, P. GROBARA, M. JOHNSTON, M. SOHNE, M. TEN WOLDE, H. BULLER. (2005) The incidence and prognostic significance of elevated cardiac troponins in patients with submassive pulmonary embolism. Journal of Thrombosis and Haemostasis 3:3, 508-513
CrossRef182
William F. Baker. (2005) Thrombolytic Therapy: Current Clinical Practice. Hematology/Oncology Clinics of North America 19:1, 147-181
CrossRef183
Paolo Prandoni. (2005) Emerging strategies for treatment of venous thromboembolism. Expert Opinion on Emerging Drugs 10:1, 87-94
CrossRef184
Darlene J. Elias. (2004) Pulmonary Embolism in Orthopaedic Patients: Diagnosis and Treatment. Techniques in Orthopaedics 19:4, 317-326
CrossRef185
Franck Verschuren, Erkki Heinonen, Didier Clause, Jean Roeseler, Fr
d
CrossRef186
Maaike Söhne, Marije ten Wolde, Harry R Büller. (2004) Biomarkers in pulmonary embolism. Current Opinion in Cardiology 19:6, 558-562
CrossRef187
S. Konstantinides, G. Hasenfu
CrossRef188
S STONE, T MORRIS. (2004) Pulmonary embolism and pregnancy. Critical Care Clinics 20:4, 661-677
CrossRef189
D.K.C. Lee. (2004) Pulmonary embolism and thrombolysis. QJM 97:10, 699-699
CrossRef190
A. Perrier. (2004) Thrombolysis in submassive pulmonary embolism. Journal of Thrombosis and Haemostasis 2:8, 1474-1475
CrossRef191
G. Agnelli, C. Becattini. (2004) Thrombolysis in submassive pulmonary embolism. Journal of Thrombosis and Haemostasis 2:8, 1477-1478
CrossRef192
M.R. Loebinger. (2004) Thrombolysis in pulmonary embolism: are we under-using it?. QJM 97:6, 361-364
CrossRef193
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Ebeling, Sally H.Ellender, Stacey M.Peters, Christine C., Goldhaber, Samuel Z., Nadel, Eric S., King, Mary Etta, Sharma, Amita, . (2004) Case 17-2004. New England Journal of Medicine 350:22, 2281-2290
Full Text194
Craig S. Kitchens. (2004) Thrombocytopenia due to acute venous thromboembolism and its role in expanding the differential diagnosis of heparin-induced thrombocytopenia. American Journal of Hematology 76:1, 69-73
CrossRef195
Samuel Z Goldhaber. (2004) Pulmonary embolism. The Lancet 363:9417, 1295-1305
CrossRef196
Kiran Yalamanchili, Arlen G. Fleisher, Stuart G. Lehrman, Howard I. Axelrod, Rocco J. Lafaro, Mohan R. Sarabu, Elias A. Zias, Richard A. Moggio. (2004) Open pulmonary embolectomy for treatment of major pulmonary embolism. The Annals of Thoracic Surgery 77:3, 819-823
CrossRef197
Henry J. Silverman, Franklin G. Miller. (2004) Control group selection in critical care randomized controlled trials evaluating interventional strategies: An ethical assessment*. Critical Care Medicine 32:3, 852-857
CrossRef198
N. Kucher, H-P. Kohler, T. Doernhoefer, D. Wallmann, B. Laemmle. (2004) Potential role of d-dimer to rule in pulmonary embolism: reply to a rebuttal. Journal of Thrombosis and Haemostasis 2:2, 369-370
CrossRef199
Masahito Sakuma, Mashio Nakamura, Norifumi Nakanishi, Yoshiyuki Miyahara, Nobuhiro Tanabe, Norikazu Yamada, Takayuki Kuriyama, Takeyoshi Kunieda, Tsuneaki Sugimoto, Takeshi Nakano, Kunio Shirato. (2004) Inferior Vena Cava Filter is a New Additional Therapeutic Option to Reduce Mortality From Acute Pulmonary Embolism. Circulation Journal 68:9, 816-821
CrossRef200
Eli V. Gelfand, Gregory Piazza, Samuel Z. Goldhaber. (2003) Venous Thromboembolism Guidebook, Fourth Edition. Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine 2:4, 247-265
CrossRef201
Edwin J.R. van Beek, Jim M. Wild, Christian Fink, Alan R. Moody, Hans-Ulrich Kauczor, Matthijs Oudkerk. (2003) MRI for the diagnosis of pulmonary embolism. Journal of Magnetic Resonance Imaging 18:6, 627-640
CrossRef202
Amjad AlMahameed, John R Bartholomew. (2003) Patients with acute pulmonary embolism should have an echocardiogram to guide treatment decisions. Medical Clinics of North America 87:6, 1251-1262
CrossRef203
Kenneth T. Horlander, Kenneth V. Leeper. (2003) Troponin levels as a guide to treatment of pulmonary embolism. Current Opinion in Pulmonary Medicine 9:5, 374-377
CrossRef204
S. Schulman. (2003) Unresolved issues in anticoagulant therapy. Journal of Thrombosis and Haemostasis 1:7, 1464-1470
CrossRef205
J. E. Dalen. (2003) Thrombolysis in submassive pulmonary embolism? No. Journal of Thrombosis and Haemostasis 1:6, 1130-1132
CrossRef206
S. Konstantinides. (2003) Thrombolysis in submassive pulmonary embolism? Yes. Journal of Thrombosis and Haemostasis 1:6, 1127-1129
CrossRef207
(2003) Scientific surgery. British Journal of Surgery 90:5, 597-597
CrossRef208
Victor F Tapson. (2003) The evolution and impact of the American College of Chest Physicians consensus statement on antithrombotic therapy. Clinics in Chest Medicine 24:1, 139-151
CrossRef209
William H Pearce. (2003) What’s new in vascular surgery. Journal of the American College of Surgeons 196:2, 253-266
CrossRef210
(2003) Thrombolytic Therapy in Patients with Submassive Pulmonary Embolism. New England Journal of Medicine 348:4, 357-359
Full Text211
Masahiro Ota, Mashio Nakamura, Norikazu Yamada, Takahiro Yazu, Ken Ishikura, Hirofumi Fujioka, Naoki Isaka, Takeshi Nakano. (2003) Association Between Antithrombotic Treatments and Prognosis of Patients With Acute Pulmonary Thromboembolism in Japan. Circulation Journal 67:7, 612-616
CrossRef212
Goldhaber, Samuel Z., . (2002) Thrombolysis for Pulmonary Embolism. New England Journal of Medicine 347:15, 1131-1132
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