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学术急诊医学档案

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  3. 卷 6 编号 1 (2018): Continuous volume
  4. Case Report

卷 6 编号 1 (2018)

一月 2018

Systemic Fibrinolytic Therapy in the Presence of Absolute Contraindication; a Case Series

  • Mahdi Pishgahi
  • Toktam Alirezaei
  • Behzad Hajimoradi
  • S.Mojtaba Nekooghadam
  • Shima Shahi

学术急诊医学档案, 卷 6 编号 1 (2018), 1 一月 2018 , 第 e25 页
https://doi.org/10.22037/aaem.v6i1.68 已出版: 2018-04-23

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摘要

In massive pulmonary embolism (PE), fibrinolytic therapy is a potential lifesaving treatment; therefore, if other treatments are not available, the physicians encounter this question: can we accept the risk of complications
from fibrinolytic therapy, especially intracranial hemorrhage, in the presence of absolute contraindication, in order to save the patient’s life? Here, we describe three cases of massive PE with absolute contraindication for
fibrinolytic therapy who presented to emergency department following dyspnea. Since, surgical or catheter embolectomy were not available and patients were very high risk for transferring to another hospital, systemic
fibrinolytic was administered. The patients improved clinically and were discharged from hospital. It seems that, if no other acceptable treatments are available, physicians could consider fibrinolytic therapy, even at the
presence of contraindication, to save the patient’s life.
关键词:
  • Massive Pulmonary embolism
  • fibrinolytic therapy
  • anticoagulant
  • absolute contraindication
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Pishgahi M, Alirezaei T, Hajimoradi B, Nekooghadam S, Shahi S. Systemic Fibrinolytic Therapy in the Presence of Absolute Contraindication; a Case Series. Arch Acad Emerg Med [网际网络]. 2018年4月23日 [见引于 2026年7月27日];6(1):e25. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/68
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参考

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Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, et al. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. Jama. 2014;311(23):2414-21.

Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg

N, Goldhaber SZ, et al.Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011;123(16):1788-830.

Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux

H, Goldhaber SZ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S-e96S.

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Stein PD, Matta F. Thrombolytic therapy in unstable patients with acute pulmonary embolism: saves lives but underused. The American journal of medicine. 2012;125(5):465-70.

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