The proper place of thrombolytic agents in the management of pulmonary embolism is not yet well defined. A number of survivors of acute massive pulmonary thromboembolism remain in a delicate balance of hemodynamic compensation and where recurrent emboli could frequently be fatal. Successful response to urokinase therapy in such a case is presented and the status of currently available thrombolytic drugs is discussed. We suggest that thrombolytic therapy in massive pulmonary embolism would provide greater hemodynamic reserve, alleviate shock, minimize the chances of recurrent emboli and prevent permanent impairment to the pulmonary vascular bed.

Fibrinolytic Agents↗

PubMedDate not supplied

Effect of age on arterial distensibility in Asymptomatic humans.

This report describes a noninvasive method by which the volume distensibility of forearm arteries can be calculated from direct measurements of pulse wave velocity. Such measurements are made at a variety of transmural arterial pressures (TMP) accomplished by placing the forearm in a cylinder and changing the pressures within. This technique eliminates arterial blood pressure as a variable, which strongly influences arterial distensibility. We studied 48 asymptomatic men and women, ages 21 to 98 years. There was considerable scatter, but significant positive relationships were demonstrated between increasing arterial distensibility and age at ambient and lower TMPs. This finding can be explained by an age-related reduction in arterial luminal diameter and an increase in arterial wall thickness which reduces arterial wall tension and more than offsets the increased stiffness produced by changes in wall composition. In six subjects, pulse tracings were simultaneously recorded on paper and analog tape. The taped curves were digitized and subjected to Fourier analysis to determine the wave velocity of individual harmonics. The characteristic wave velocity was defined and found comparable to the hand method used in the same beats (regression coefficient = + 0.97). These data indicate that the automatic and manual methods measured the same variable.

Adult↗