Objective: To assess the efficacy and safety of thrombolytic treatment with
reteplase in patients with intermediate-risk acute
pulmonary embolism. Methods: Ten consecutive patients with intermediate-risk acute
pulmonary embolism who received thrombolytic treatment with
reteplase at
Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and
biochemical markers were assessed before and after
thrombolytic therapy with
reteplase, and
bleeding complications were also observed during 3 months follow up. Results: (1) For the efficacy outcomes: at 48 hours after thrombolytic treatment with
reteplase, echocardiography-derived diameter of right ventricular was significant reduced from (27.9±3.8) mm to (24.8±2.6) mm (P=0.03), systolic pulmonary artery pressure decreased from (63.9±21.6) mmHg(1 mmHg=0.133 kPa) to (34.4±19.8) mmHg (P=0.02). Heart rate and breathing rate were also decreased significantly (both P<0.05), blood pressure remained unchanged post
therapy.Hypoxemia was quickly corrected with an significant elevation of PaO(2) and SaO(2) ((65.2±14.3) mmHg vs. (80.0±9.6) mmHg, P=0.006; (90.8±3.5)% vs. (95.2 ±1.6)%, P=0.002 respectively). PaCO(2) was also increased significantly (P<0.05). Serum
NT-proBNP and cTnI were decreased significantly (both P<0.05). There was no recurrent
pulmonary embolism or
deep-vein thrombosis during the 3 months follow-up. (2) For the safety outcomes: a thrombolytic relevant
hemoptysis (about 70 ml) occurred in 1 patient, and was controlled by PCC
therapy.No other clinically relevant events were observed during thrombolytic treatment. Eight patients were followed more than 3 months, there was no major
bleeding complication or death during the follow up period. Conclusion: Treatment of intermediate-risk acute
pulmonary embolism with
reteplase is effective and safe and there are no obvious side effects.