Massive pulmonary embolism with shock: Role of thrombolysis using central venous access

Research output: Contribution to journalReview article

Abstract

BACKGROUND: Massive pulmonary embolism (PE) complicated with shock has an extremely high mortality rate with medical treatment. Since access to emergency vascular surgery or endovascular specialists is not readily available in most centers, patients are frequently treated with thrombolytic agents delivered via a peripheral venous access. Patients with shock, however, have poor peripheral perfusion, and peripheral administration of thrombolytic agents may thus not reliably deliver the agent to the embolus, reducing treatment efficacy. OBJECTIVE: This report discusses the role of thrombolysis administered via central venous access in PE with shock. CASE REPORT: This report describes the case of a 46-year-old man presenting with newonset atrial fibrillation, right bundle branch block, and shock from a massive PE. In view of shock, thrombolytics were given via a subclavian central venous catheter. He improved dramatically within 1 hour, with prompt resolution of the shock and the dysrhythmia.

Original languageEnglish (US)
Pages (from-to)E321-E324
JournalJournal of Invasive Cardiology
Volume24
Issue number12
StatePublished - Dec 1 2012
Externally publishedYes

Keywords

  • Central venous access
  • Pulmonary embolish
  • Thrombolysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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