Сhoice of a thrombolytic for pulmonary thromboembolism treatment

Authors

  • Olexander Nykonenko DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096, Ukraine
  • Andriy Nykonenko Zaporizhzhia State Medical University Mayakovskoho ave., 26, Zaporizhzhia, Ukraine, 69035, Ukraine https://orcid.org/0000-0002-5720-2602
  • Serhii Matvieiev Zaporizhzhia State Medical University Mayakovskoho ave., 26, Zaporizhzhia, Ukraine, 69035, Ukraine https://orcid.org/0000-0002-6808-5376
  • Viacheslav Osaulenko DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096, Ukraine
  • Serhii Nakonechny DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096, Ukraine

DOI:

https://doi.org/10.15587/2519-4798.2017.113324

Keywords:

thromboembolism of pulmonary artery, computer tomography, Miller index, streptokinase, alteplase

Abstract

Aim of the study was to choose the optimal thrombolytic therapy for massive and submassive TEPA.

Materials and methods. 102 patients with massive and submassive embolism of lungs (Miller index > 17) were arbitrarily divided for administrating 100 mg of the recombinant tissue activator of plasminogen (r-tPA) or 3 mln of UN of streptokinase. The control multi-spiral computer tomography of breast organs (MSCT BO) or angiopulmonography (APG) was realized in 2–3 days after thrombolysis. For calculating the statistical importance of the difference of the number of patients by the concomitant pathology and sex, there was used χ2 with Ets correction. Mann-Whitney criterion was used for calculating the difference by age.

Results. There was established the advantage of using r-tPA in hemodynamically unstable patients. There was established the advantage of using streptokinase in patients with the disease duration more than 1 day. There was proved the effectiveness of repeated sessions of thrombolysis. There was established, that it’s possible to prevent hemorrhagic complications of thrombolysis if to reveal its contraindications accurately.

Conclusions. Alteplase must be used in hemodynamically unstable patients due to the faster effect comparing with streptokinase. Alteplase or streptokinase must be used for hemodynamically stable patients with massive and submassive pulmonary embolism. The repeated TLT is equally effective as thromboembolectomy at insufficient effectiveness of thrombolysis. For preventing hemorrhagic complications, the detail examination of patients is necessary to reveal possible sources of fatal bleeding and determination of contraindications to TLT

Author Biographies

Olexander Nykonenko, DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096

MD, Professor, Academician of NAMS of Ukraine, Corresponding Member of NAS of Ukraine

Rector

Andriy Nykonenko, Zaporizhzhia State Medical University Mayakovskoho ave., 26, Zaporizhzhia, Ukraine, 69035

MD, Professor

Department of Hospital Surgery

Serhii Matvieiev, Zaporizhzhia State Medical University Mayakovskoho ave., 26, Zaporizhzhia, Ukraine, 69035

Postgraduate Student

Department of Hospital Surgery

Viacheslav Osaulenko, DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096

PhD, Associate Professor

Department of the cardiosurgery

Serhii Nakonechny, DZ "Zaporizhzhya Medical Academy of Postgraduate Education Ministry of Health of Ukraine" Vintera blvd., 20, Zaporizhzhia, Ukraine, 69096

PhD, Associate Professor

Department of Radiation Diagnostics

References

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Published

2017-10-31

How to Cite

Nykonenko, O., Nykonenko, A., Matvieiev, S., Osaulenko, V., & Nakonechny, S. (2017). Сhoice of a thrombolytic for pulmonary thromboembolism treatment. ScienceRise: Medical Science, (10 (18), 28–33. https://doi.org/10.15587/2519-4798.2017.113324

Issue

Section

Medical Science