title: Massive pulmonary embolism in pregnancy treated with catheter-directed tissue plasminogen activator.
abstract: Pulmonary embolism is a leading cause of maternal death in the United States, contributing to the death of approximately 2 women per 100,000 live births each year. Thrombosis during pregnancy traditionally is treated conservatively with unfractionated heparin or low-molecular-weight heparin; however, cardiovascular collapse associated with a large pulmonary embolus may require immediate aggressive intervention to save the mother and fetus. We report the use of catheter infusion thrombolysis in the successful management of a third-trimester pregnant patient with a hemodynamically significant saddle pulmonary embolus.
authors.affiliation: From the Departments of *Anesthesiology, †Medicine, and ‡Radiology, New York Presbyterian Medical Center, Weill Medical College of Cornell University, New York, New York.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Pick
authors.forename: David
authors.initials: D
authors.lastname: Berlin
authors.forename: James
authors.initials: J
authors.lastname: Horowitz
authors.forename: Ron
authors.initials: R
authors.lastname: Winokur
authors.forename: Akhilesh K
authors.initials: AK
authors.lastname: Sista
authors.forename: Adam D
authors.initials: AD
authors.lastname: Lichtman
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011655:Pulmonary Embolism / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D062666:Vascular Access Devices
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D010959:Tissue Plasminogen Activator