Individual fibrinolytic potential in patients with acute pulmonary embolism undergoing ultrasound assisted catheter directed thrombolysis
Dominik F. Draxler MD PhD, Department of cardiology, Inselspital Bern, Department for Biomedical Research, University of Bern. For more information, please visit the website
Pulmonary embolism (PE) is commonly treated with thrombolysis in selected high-risk patients, which is associated with high bleeding rates. Catheter directed thrombolysis (CDT) has emerged as an alternative treatment with an improved risk-benefit ratio.
Curiously, the thrombolytic agent, recombinant tissue-type plasminogen activator (rt-PA), itself is actually not directly degrading the fibrin clot, but rather activating the zymogen plasminogen to the fibrinolytic effector protease plasmin. Hence, the individual potential to activate fibrinolysis in response to treatment may serve as a useful additional parameter in the decision to perform lysis or to adjust the rt-PA dose to achieve maximal efficacy and safety.