{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:02:48Z","timestamp":1780452168057,"version":"3.54.1"},"reference-count":11,"publisher":"Texas Heart Institute Journal","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:p>Massive pulmonary embolism is associated with mortality rates exceeding 50%. Current practice guidelines include the immediate administration of thrombolytic therapy in the absence of contraindications. However, thrombolysis for pulmonary embolism is said to be absolutely contraindicated in the presence of recent hemorrhagic stroke and other conditions. The current contraindications to thrombolytic therapy have been extrapolated from data on acute coronary syndrome and are not specific for venous thromboembolic disease. Some investigators have proposed that the current contraindications be viewed as relative, rather than absolute, in cases of high-risk pulmonary embolism.<\/jats:p>\n        <jats:p>We present the case of a 60-year-old woman in whom massive pulmonary embolism led to cardiac arrest with pulseless electrical activity. Eight weeks earlier, she had sustained a hemorrhagic cerebrovascular accident\u2014a classic absolute contraindication to thrombolytic therapy. Despite this practice guideline, we administered tissue plasminogen activator systemically in order to save the patient's life. This therapy did not evoke intracranial bleeding, and the patient was eventually discharged from the hospital. Until guidelines specific to venous thromboembolic disease are developed, we think that the current contraindications to thrombolysis should be considered on an individual basis in patients who are at high risk of death from massive pulmonary embolism.<\/jats:p>","DOI":"10.14503\/thij-12-3010","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T16:43:24Z","timestamp":1396370604000},"page":"174-176","source":"Crossref","is-referenced-by-count":10,"title":["Life-Saving Systemic Thrombolysis in a Patient with Massive Pulmonary Embolism and a Recent Hemorrhagic Cerebrovascular Accident"],"prefix":"10.14503","volume":"41","author":[{"given":"Wendy","family":"Bottinor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Turlington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Raza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte S.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ion S.","family":"Jovin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Abbate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5628","reference":[{"issue":"3","key":"i0730-2347-41-2-174-b1","series-title":"J Thromb Thrombolysis","first-page":"227","article-title":"Streptokinase and heparin versus heparin alone in massive pulmonary embolism: a randomized controlled trial","volume":"2","year":"1995","unstructured":"Jerjes-Sanchez\n              C\n            , Ramirez-RiveraA, de Lourdes GarciaM, Arriaga-NavaR, ValenciaS, Rosado-BuzzoA, et al. Streptokinase and heparin versus heparin alone in massive pulmonary embolism: a randomized controlled trial. J Thromb Thrombolysis1995;2(3):227\u20139."},{"issue":"6","key":"i0730-2347-41-2-174-b2","series-title":"Curr Opin Cardiol","first-page":"560","article-title":"Therapy for acute high-risk pulmonary embolism: thrombolytic therapy and embolectomy","volume":"25","year":"2010","unstructured":"Meneveau\n              N.\n            \n          \n          Therapy for acute high-risk pulmonary embolism: thrombolytic therapy and embolectomy. Curr Opin Cardiol2010;25(6):560\u20137."},{"issue":"2 Suppl","key":"i0730-2347-41-2-174-b3","series-title":"Chest","first-page":"e419S","article-title":"Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines [published erratum appears in Chest 2012;142(6):1698\u2013704]","volume":"141","year":"2012","unstructured":"Kearon\n              C\n            , AklEA, ComerotaAJ, PrandoniP, BounameauxH, GoldhaberSZ, et al. Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines [published erratum appears in Chest 2012;142(6):1698\u2013704]. Chest2012;141(2 Suppl):e419S\u201394S."},{"issue":"18","key":"i0730-2347-41-2-174-b4","series-title":"Eur Heart J","first-page":"2276","article-title":"Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)","volume":"29","year":"2008","unstructured":"Torbicki\n              A\n            , PerrierA, KonstantinidesS, AgnelliG, GalieN, PruszczykP, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J2008;29(18):2276\u2013315."},{"issue":"3","key":"i0730-2347-41-2-174-b5","series-title":"Top Stroke Rehabil","first-page":"61","article-title":"Prevention of venous thromboembolism after stroke","volume":"10","year":"2003","unstructured":"Harvey\n              RL.\n            \n          \n          Prevention of venous thromboembolism after stroke. Top Stroke Rehabil2003;10(3):61\u20139."},{"issue":"2","key":"i0730-2347-41-2-174-b6","series-title":"Semin Respir Crit Care Med","first-page":"176","article-title":"Interventional approaches in VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction)","volume":"33","year":"2012","unstructured":"Imberti\n              D\n            , MaraldiC, GalleraniM.\n          Interventional approaches in VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction). Semin Respir Crit Care Med2012; 33(2):176\u201385."},{"issue":"3","key":"i0730-2347-41-2-174-b7","series-title":"Perspect Vasc Surg Endovasc Ther","first-page":"171","article-title":"Endovascular interventions for acute pulmonary embolism","volume":"22","year":"2010","unstructured":"Lin\n              PH\n            , ChenH, BecharaCF, KougiasP.\n          Endovascular interventions for acute pulmonary embolism. Perspect Vasc Surg Endovasc Ther2010;22(3):171\u201382."},{"issue":"1","key":"i0730-2347-41-2-174-b8","series-title":"Resuscitation","first-page":"154","article-title":"Successful resuscitation with thrombolysis of a patient suffering fulminant pulmonary embolism after recent intracerebral haemorrhage","volume":"72","year":"2007","unstructured":"Koroneos\n              A\n            , KoutsoukouA, ZervakisD, PolitisP, SourlasS, PagoniE, RoussosC.\n          Successful resuscitation with thrombolysis of a patient suffering fulminant pulmonary embolism after recent intracerebral haemorrhage. Resuscitation2007;72 (1):154\u20137."},{"issue":"1","key":"i0730-2347-41-2-174-b9","series-title":"Mayo Clin Proc","first-page":"99","article-title":"Systemic thrombolytic therapy after recent abdominal aortic aneurysm repair: an absolute contra-indication?","volume":"78","year":"2003","unstructured":"Cable\n              DG\n            , CherryKJ.\n          Systemic thrombolytic therapy after recent abdominal aortic aneurysm repair: an absolute contra-indication?\n          Mayo Clin Proc\n          2003;78(1):99\u2013102."},{"issue":"4","key":"i0730-2347-41-2-174-b10","series-title":"J Intensive Care Med","first-page":"240","article-title":"Thrombolytic therapy for massive pulmonary embolism in a patient with a known intracranial tumor","volume":"21","year":"2006","unstructured":"Han\n              S\n            , ChayaC, HooGW.\n          Thrombolytic therapy for massive pulmonary embolism in a patient with a known intracranial tumor. J Intensive Care Med2006;21(4):240\u20135."},{"issue":"8","key":"i0730-2347-41-2-174-b11","series-title":"J Clin Neurosci","first-page":"917","article-title":"Thrombolysis for concomitant acute stroke and pulmonary embolism","volume":"15","year":"2008","unstructured":"Allport\n              LE\n            , ButcherKS.\n          Thrombolysis for concomitant acute stroke and pulmonary embolism. J Clin Neurosci2008;15 (8):917\u201320."}],"container-title":["Texas Heart Institute Journal"],"original-title":[],"link":[{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/41\/2\/article-p174.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/thij\/article-pdf\/41\/2\/174\/2549219\/thij-12-3010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/41\/2\/article-p174.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/41\/2\/article-p174.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:31:08Z","timestamp":1730993468000},"score":1,"resource":{"primary":{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/41\/2\/article-p174.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":11,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.14503\/thij-12-3010","relation":{},"ISSN":["0730-2347","1526-6702"],"issn-type":[{"value":"0730-2347","type":"print"},{"value":"1526-6702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4]]}}}