SUCCESSFUL TREATMENT OF PULMONARY EMBOLISM AND ASSOCIATED UPPER EXTREMITY ARTERY THROMBOSIS USING INTRAVENOUS ALTEPLASE: A CASE REPORT

Year 2019, Volume: 10 Issue: 2, 39 - 42, 01.04.2019

Kivanc Karaman , Cihangir Celik Alten Oskay , Hamit Hakan Armağan , Onder Tomruk

https://doi.org/10.33706/jemcr.551134

Abstract

Introduction: Although thrombolytic
administration is inevitable in the management of massive pulmonary embolism,
contradictions exist in the treatment of sub-massive pulmonary embolism. There
are drawbacks to thrombolytic treatment due to potential serious side effects
such as cranial hemorrhage.

Case Report: An 84-year-old female patient was
admitted to the emergency service because of pain and lack of a pulse in her
right arm and %61 oxygen saturation without any respiratory system complaints.
A computerized tomography showed pulmonary embolism close to totality in the
bilateral main pulmonary arteries and peripheral embolism in the right brachial
artery. We considered a sub-massive pulmonary embolism in this patient with no
hypotension despite bilateral pulmonary artery embolism, good general
condition, but a dilated right ventriculi in transthoracic echocardiography.
Since the PESI score was 115, it was decided that the patient was in the
high-risk group. After administration of 100 mg Alteplase as thrombolytic
therapy, her oxygen saturation increased to 95% in the room air and her
complaint of right arm completely regressed. Furthermore, none of the possible
complications from thrombolytic therapy, such as fatal bleeding, were observed
in our patient.

Conclusion: In this article, it is emphasized
that thrombolytic therapy is an appropriate choice for patients with
sub-massive pulmonary embolism and acute arterial embolism.

Keywords

Emergency service, Peripheral arterial embolism, Pulmonary embolism

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