title: Resolution of pulmonary embolism: effect of therapy and putative age of emboli.
abstract: The purpose of this study was to evaluate functional and scintigraphic improvement in patients with pulmonary embolism (PE) according to the kind of treatment and the putative age of the emboli. The study includes 20 patients with both scintigraphic and angiographic diagnosis of PE enrolled in Pisa as a part of two previous multicenter trials: PAIMS 2 and BAPE. All patients were admitted to the Pulmonary Unit of the University of Pisa and treated with recombinant tissue-type plasminogen activator (rt-PA) plus heparin (H) (n = 10) or with H alone (n = 10). Results confirmed previous data, namely that perfusion damage decreases significantly from embolization to 7 days later in both patients treated with rt-PA + H and H alone (p < 0.001), although patients treated with rt-PA + H have a significantly higher perfusion restoration (p < 0.001) and a standard PaO2 increase (p < 0.01). Interestingly, our data also showed that the putative age of the emboli does not influence the efficacy of rt-PA + H treatment, while it does influence that of H treatment alone; in other words, rt-PA + H therapy may act efficaciously not only in fresh, but also in old pulmonary emboli.
authors.affiliation: Istituto di Fisiologia Clinica, CNR, Università degli Studi di Pisa, Italia.
authors.forename: A
authors.initials: A
authors.lastname: Palla
authors.forename: M
authors.initials: M
authors.lastname: Pazzagli
authors.forename: D
authors.initials: D
authors.lastname: Manganelli
authors.forename: P
authors.initials: P
authors.lastname: De Nitto
authors.forename: C
authors.initials: C
authors.lastname: Marini
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.forename: D
authors.initials: D
authors.lastname: Mazzantini
authors.forename: C
authors.initials: C
authors.lastname: Giuntini
mesh_terms: D000704:Analysis of Variance; D001784:Blood Gas Analysis; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011859:Radiography; D011877:Radionuclide Imaging; D011994:Recombinant Proteins; D012189:Retrospective Studies; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D006493:Heparin; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator