Pulmonary Embolism: Long‐term Follow‐up after Treatment with Full‐dose Heparin, Streptokinase or Embolectomy

Abstract

Lund, O, Nielsen, TT, Rønne, K, Schifter S (Departments of Thoracic and Cardiovascular Surgery, Cardiology, Respiratory Diseases, and Clinical Physiology and Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark). Pulmonary Embolism: Long‐term follow‐up after treatment with full‐dose heparin, streptokinase or embolectomy. Acta Med Scand 1987; 221:61–71. The study comprises 74 patients alive 30 days after the start of treatment of pulmonary embolism with heparin (n=32), streptokinase (n=22) or embolectomy (n=20). The cumulative 5‐year survival was 100% in the embolectomy group, compared to 75±7% (SE) in the medically treated patients (pp1.5 mmHg/1/min), depressed ventilatory function and more than 25% reduced pulmonary perfusion at follow‐up. The major prognostic factors thus were cancer, the number of recurrent episodes and the degree of cardiocirculatory affection in the acute event. Although the embolectomized patients were the most affected initially, they had a good prognosis. This led us to extend our indications for embolectomy to include all patients with central emboli, irrespective of the degree of cardiocirculatory impairment.