This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Petitpretz, P. Articles by Duroux, P. Search for Related Content PubMed PubMed Citation Articles by Petitpretz, P. Articles by Duroux, P.

Circulation, Vol 70, 861-866, Copyright © 1984 by American Heart Association

ARTICLES

Effects of a single bolus of urokinase in patients with life- threatening pulmonary emboli: a descriptive trial

P Petitpretz, G Simmoneau, J Cerrina, D Musset, M Dreyfus, MD Vandenbroek and P Duroux

To evaluate hemodynamic, angiographic, and biological effects of a single bolus of urokinase, an open descriptive trial was conducted in a homogeneous group of 14 patients with acute life-threatening pulmonary emboli and without prior cardiopulmonary disease. For every patient the efficacy of the treatment was evaluated by comparing control and posttherapeutic values after the bolus injection of 15,000 IU/kg body weight urokinase (urinary source) administered in 10 min in the right atrium, followed by continuous intravenous full-dose heparin therapy. In two patients clinical status, hemodynamics, vascular obstruction, and biological (fibrinogen and plasminogen levels) parameters remained unchanged. One of these two patients died, making the mortality rate for the whole group 7%. Twelve of 14 patients showed rapid clinical improvement. Evaluation at 12 hr demonstrated significant decreases in pulmonary vascular obstruction (Miller index, 34%), total pulmonary vascular resistances (37%), and fibrinogen and plasminogen levels (41% and 40%, respectively), without any significant change in cardiac index. The hemodynamic sequential measurements performed (1,3, 6, and 12 hr) in seven of the 12 improved patients showed that the greatest percentage of the total hemodynamic improvement occurred within the first 3 hr after bolus administration of urokinase. No severe hemorrhagic complications were observed. Because of its rapid efficacy and its low cost, the bolus technique appeared particularly useful in the treatment of patients with acute life-threatening pulmonary emboli.

This article has been cited by other articles:

				N. Meneveau, L. P. Ming, M. F. Seronde, N. Mersin, F. Schiele, F. Caulfield, Y. Bernard, and J.-P. Bassand In-hospital and long-term outcome after sub-massive and massive pulmonary embolism submitted to thrombolytic therapy Eur. Heart J., August 1, 2003; 24(15): 1447 - 1454. [Abstract] [Full Text] [PDF]

				G. S. Ahearn, D. Hadjiliadis, J. A. Govert, and V. F. Tapson Massive Pulmonary Embolism During Pregnancy Successfully Treated With Recombinant Tissue Plasminogen Activator: A Case Report and Review of Treatment Options Arch Intern Med, June 10, 2002; 162(11): 1221 - 1227. [Full Text] [PDF]

				K. E. Wood Major Pulmonary Embolism : Review of a Pathophysiologic Approach to the Golden Hour of Hemodynamically Significant Pulmonary Embolism Chest, March 1, 2002; 121(3): 877 - 905. [Abstract] [Full Text] [PDF]

				M.D. Thomas, A. Chauhan, and R.S. More Pulmonary embolism--an update on thrombolytic therapy QJM, May 1, 2000; 93(5): 261 - 267. [Full Text] [PDF]

				S. M. Arcasoy and J. W. Kreit Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence Chest, June 1, 1999; 115(6): 1695 - 1707. [Abstract] [Full Text] [PDF]

				F. Venuta, E. A. Rendina, T. De Giacomo, and G. F. Coloni Catheter Fragmentation of Pulmonary Emboli Chest, June 1, 1999; 115(6): 1759 - 1759. [Full Text] [PDF]