Tenecteplase for the treatment of massive and submassive pulmonary embolism.
BACKGROUND
Data on thrombolytic therapy disclose benefits from thrombolytic therapy in patients with massive and submassive pulmonary embolism (PE). Previously published case reports have described the successful use of tenecteplase under these conditions.


METHODS
Four patients with massive and submassive PE received a weight-optimized dosing regimen of tenecteplase, administered as an intravenous bolus.


RESULTS
All patients experienced clinically relevant improvement of dyspnea following thrombus regression. Regression of right ventricular enlargement was documented in three cases. Tenecteplase was well tolerated and did not cause bleeding complications. Thirty-day mortality was zero.


CONCLUSIONS
These data support the use of this new thrombolytic agent in patients with massive and submassive PE; however, sufficiently powered, randomized trials have not yet taken place for these indications.
Melzer
Christoph
C
Medical Clinic, Charité Hospital, Schumannstrasse 20/21, D-10117 Berlin, Germany. christoph.melzer@charite.de
Richter
Christoph
C
Rogalla
Patrick
P
Borges
Adrian Constantin
AC
Theres
Heinz
H
Baumann
Gert
G
Laule
Michael
M
D000368:Aged; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D000077785:Tenecteplase; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase