title: Role of tenecteplase in pulmonary embolism.
abstract: Patients presenting with pulmonary embolism (PE) have a wide spectrum of clinical severity. Although, some patients may present with frank hemodynamic collapse and cardiac arrest, others may present with asymptomatic PE that is discovered incidentally during work up of another condition. Fibrinolytic therapy is an option in the treatment of patients with PE. A rational approach to decide whether to indicate fibrinolytic therapy is based on assessment of benefits that each patient will derive from fibrinolytic therapy weighed against risk of major bleeding and intracranial hemmorage. There is a clear benefit/risk ratio for fibrinolytic therapy in patients with PE who present with cardiac arrest and in those who are hemodynamically unstable from a massive pulmonary embolism. With proper risk assessment selected patients with stable hemodynamics and right ventricular dysfunction may also benefit from fibrinolytic therapy. This article sets out to review the literature on tenecteplase in treatment of patients with PE.
authors.affiliation: Escorts Heart Institute and Research Centre, Okhla, New Delhi, India. sameer_rashmi@hotmail.com
authors.forename: Sameer
authors.initials: S
authors.lastname: Shrivastava
authors.forename: Ankush
authors.initials: A
authors.lastname: Sachdeva
authors.forename: Biswajit
authors.initials: B
authors.lastname: Paul
mesh_terms: D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D000077785:Tenecteplase; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016278:Ventricular Function, Right / Q000187:drug effects
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase