Successful Thrombolysis in Postoperative Patients With Acute Massive Pulmonary Embolism

Purpose The standard medical management for patients with acute massive pulmonary embolism (MPE) is systemic thrombolysis. However, it is generally thought that recent surgeries are a contraindication to thrombolytic therapy. In this study, we evaluated the efficacy and safety of systemic thrombolysis for postoperative patients with acute MPE and assessed the risk of bleeding. Methods A retrospective review was performed on 21 postoperative patients with MPE in a timeframe of five years (from 2005 to 2010). The criteria for study inclusion were postoperative patients who received systemic thrombolysis for confirmed acute MPE within three weeks after surgery. Results Seventeen postoperative patients, including men (12) and women (five) aged 53 ± 16 (range 23–71) years, were treated with systemic thrombolysis. Significant haemodynamic improvement (shock index  Conclusion Recent surgery is not an absolute contraindication to systemic thrombolysis. Further, to obtain a successful outcome, it is crucial to exclude patients who have received neurosurgical operations or those with other contraindications to thrombolytic therapy.