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10.5606/tgkdc.dergisi.2012.074
A successful thrombolysis with tissue-type plasminogen activator in a case of pulmonary embolism after failed streptokinase therapy
Mehmet Kayrak, Yusuf Alihanoğlu, Enes Elvin Gül, Turyan Abdulhalikov, Osman Sönmez, Mehmet Yazıcı
Department of Cardiology, Medicine Faculty of Selçuk University, Konya, Turkey
DOI : 10.5606/tgkdc.dergisi.2012.074
A 76-year-old male patient diagnosed with acute, massive
pulmonary embolism due to deep vein thrombosis of
a lower extremity developed significant cardiovascular
and respiratory instability. Subsequently, streptokinase
infusion was administered over two hours. Spiral
computed tomography was performed due to the persistent
hemodynamic instability following the thrombolytic
therapy. Computed tomography showed persistent massive
pulmonary embolism. In the light of literature data, the patient
was recommended for surgical pulmonary embolectomy,
however he refused surgery. Therefore, he was administered
intravenous recombinant tissue type plasminogen activator
over two hours. Clinic status of the patient and radiological
findings were significantly improved following therapy. The
patient was discharged with effective anticoagulant therapy.
Keywords : Computed tomography; pulmonary embolism; thrombolytic therapy
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