RESOLUTION OF PULMONARY-EMBOLISM - EFFECT OF THERAPY AND PUTATIVE AGEOF EMBOLI

The purpose of this study was to evaluate functional and scintigraphic improvement in patients with pulmonary embolism (PE) according to the kind of treatment and the putative age of the emboli, The study inclu des 20 patients with both scintigraphic and angiographic diagnosis of PE enrolled in Pisa as a part of two previous multicenter trials: PAIM S 2 and BAPE. All patients were admitted to the Pulmonary Unit of the University of Pisa and treated with recombinant tissue-type plasminoge n activator (rt-PA) plus heparin (H) (n = 10) or with H alone (n = 10) . Results confirmed previous data, namely that perfusion damage decrea ses significantly from embolization to 7 days later in both patients t reated with rt-PA + H and H alone (p < 0.001), although patients treat ed with rt-PA + H have a significantly higher perfusion restoration (p < 0.001) and a standard PaO2 increase (p < 0.01). Interestingly, our data also showed that the putative age of the emboli does not influenc e the efficacy of rt-PA + H treatment, while it does influence that of H treatment alone; in other words, rt-PA + H therapy may act efficaci ously not only in fresh, but also in old pulmonary emboli.