Urokinase therapy in pulmonary thromboembolism

Abstract

Thirteen patients with angiographically confirmed pulmonary thromboembolism received thrombolytic therapy with urokinase for 8 to 12 hours. Cardiac catheterization lung scan and angiograms prior to and within 6 to 18 hours after completion of therapy were used to assess results. Five patients with acute symptoms had marked improvement in clinical and laboratory parameters. Of 4 patients with sub-acute symptoms, all had clinical improvement but objective studies were less changed than in the acute group. Three chronic patients were treated and failed to demonstrate significant change in any parameter. One patient with acute symptoms died and was found to have only old organized, adherent emboli, pointing out the difficulty in predicting the characteristics of emboli by presently available methods. The lytic state was tolerated well by even severely ill patients and bleeding into soft tissue represented the only recognized complication. Further controlled observations of this form of therapy are considered justified in patients with acute massive pulmonary embolism.