ReviewJournal of thrombosis and thrombolysis2019
Thrombolysis in hemodynamically unstable patients: still underused: a review based on multicenter prospective registries on acute pulmonary embolism.
Review in Journal of thrombosis and thrombolysis, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Robustness and fragility of evidence supporting systemic thrombolysis in acute pulmonary embolism.Journal of thrombosis and thrombolysis · 2026Pooled it
- Prognostic impact of the e-TAPSE ratio in intermediate-high risk pulmonary embolism patients.The international journal of cardiovascular imaging · 2024Trial
- Reperfusion Therapy and Outcomes in High-Risk Pulmonary Embolism: Multicenter Registry Study From the Tokyo Cardiovascular Care Unit Network.Circulation reports · 2026Article
- Article
- Intermediate-high-risk pulmonary embolism in a 53-year-old woman with colorectal cancer and contraindication to thrombolysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Aspiration thrombectomy compared to catheter directed thrombolysis in pulmonary embolism: Outcomes from a tertiary referral center.Cardiology journal · 2025Article
- Sex Differences in Advanced Therapeutic Interventions for Intermediate- and High-Risk Pulmonary Embolism.Clinical therapeutics · 2024Article
- Systemic Thrombolysis is Still the First-Line Treatment for Unstable Pulmonary Embolism.JACC. Advances · 2024Article
- Management of high-risk pulmonary embolism in the emergency department: A narrative review.The American journal of emergency medicine · 2024Review
- Addressing the rising trend of high-risk pulmonary embolism mortality: Clinical and research priorities.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Comparison of In-Hospital Outcomes between Early and Late Catheter-Directed Thrombolysis in Acute Pulmonary Embolism: A Retrospective Observational Study.Journal of clinical medicine · 2024Article
- Catheter Interventions for Pulmonary Embolism: Mechanical Thrombectomy Versus Thrombolytics.Methodist DeBakey cardiovascular journal · 2024Review
- [Ultrasound-accelerated thrombolysis. Initial experience in patients with contraindications to systemic thrombolysis].Revista medica del Instituto Mexicano del Seguro Social · 2023Review
- Immediate and late impact of reperfusion therapies in acute pulmonary embolism.European heart journal supplements : journal of the European Society of Cardiology · 2019Article
- Is there an optimal "door to cath time" in the treatment of acute pulmonary embolism with catheter-directed thrombolysis?Annals of translational medicine · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemodynamically unstable pulmonary embolism (PE) represents a complex and life-threatening event with a highly variable course and poor prognosis in the short-term period. Despite an immediate reperfusion treatment is recommended in these patients, previous investigations have reported a lower use of systemic thrombolysis (ST). The aim of the present review is to assess and describe the real use of ST in hemodynamically unstable patients with acute PE enrolled in prospective-multicenter registries between the 1990 and 2018. Over that period, 1216 articles were identified in Pubmed. After excluding the duplicates obtained using the different searching MeSH (n = 703), 513 articles were screened and then excluded for not meeting inclusion criteria due the article type, design of the study or no English language. As result, 13 articles were assessed for eligibility and carefully reviewed. Finally, five studies met the inclusion criteria and were included in the analysis. The identified study registries enrolled prospectively 41364 consecutive patients with acute PE between the 1993 and the 2016. Among these, 2168 (5.2%) were hemodynamically unstable at presentation. ST was administered in 29.7% (n = 645) of patients while catheter-direct treatment (CDT) was used only in 1.4% (n = 32) of cases. Conversely, surgical pulmonary embolectomy (SPE) was adopted as reperfusion treatment in 39 patients (1.7%). Intriguingly, the 68% of patients not received a reperfusion treatment despite they were hemodynamically unstable at admission. Despite the internationals guidelines recommendations, a prompt reperfusion is performed only in one on three hemodynamically unstable patients with acute PE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.