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Evid Based Med 18:e19 doi:10.1136/eb-2012-100848
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Thrombolytic therapy with or without a vena cava filter results in a lower case fatality rate in unstable patients with acute pulmonary embolism

  1. Said A Ibrahim2,3
  1. 1Division of General Internal Medicine, Bern University Hospital, 3010 Bern, Switzerland
  2. 2Co-Director, VA Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, University & Woodland Avenues, Philadelphia, PA 19104, USA
  3. 3Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Blockley Hall, 423 guardian drive, Philadelphia, PA 19104, USA
  1. Correspondence to Dr Said A Ibrahim
    Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Blockley Hall, 423 guardian drive, Philadelphia, PA19104, USA; said.ibrahim2{at}va.gov

Commentary on:

Context

Acute pulmonary embolism (PE) is a major health problem and is associated with significant morbidity and mortality. This is particularly true for patients with acute PE who are haemodynamically unstable.1 For instance, acute PE is associated with a 70% risk of death if cardiopulmonary arrest occurs and up to a 50% risk of death in those with shock secondary to PE.1 ,2 Several trials have evaluated the prognostic impact of thrombolytic therapy compared with anticoagulant therapy alone in patients with acute PE.1 Since less than 5% of patients with acute PE are haemodynamically compromised, there are currently no randomised trials evaluating the impact …

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