Pulmonary embolism treated with a single dose of anisoylated lys-plasminogen streptokinase activator complex and systemic heparinization; a report of two cases.
Pulmonary embolism (PE) is an important cause of morbidity and mortality in the Western World. Systemic heparinization is usually applied as the treatment of first choice. However, a subgroup of patients presenting with massive PE and haemodynamic deterioration die in the acute phase or remain severely disabled. Several studies have demonstrated the beneficial effects of thrombolytic agents in the treatment of massive PE. This communication presents two patients with clinically massive PE of recent onset (confirmed by lung perfusion scans) who were successfully treated with a single i.v. dose of 30 mg of anisoylated lys-plasminogen streptokinase activator complex (APSAC, comparable to 1,500,000 U of streptokinase) followed by systemic heparinization for 7 days. Both patients showed a considerable improvement in their clinical condition shortly after APSAC administration. Control perfusion scans made after two days revealed marked reduction of perfusion defects.