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Vol. 6 No. 1 (2018)

November 2017

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

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

EMERGENCY , Vol. 6 No. 1 (2018), 19 November 2017 , Page e25
https://doi.org/10.22037/emergency.v6i1.21162 Published: 2018-04-21

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Abstract

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.

Keywords:
  • Massive Pulmonary embolism
  • fibrinolytic therapy
  • anticoagulant
  • absolute contraindication
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References

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