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  Administration of Thrombolytic Treatment for Massive Pulmonary Embolism in A Patient on Prasugrel [Respir Case Rep]
Respir Case Rep. 2017; 6(3): 149-152 | DOI: 10.5505/respircase.2017.65002  

Administration of Thrombolytic Treatment for Massive Pulmonary Embolism in A Patient on Prasugrel

Ayşe Baha1, Reşat Mehmet Baha2, İbrahim Yıldız3
1Department of Pulmonary Medicine, Ufuk University Faculty of Medicine, Ankara, Turkey
2Department of Cardiology, Medicalpark Hospital, Ankara, Turkey
3Department of Cardiology, Osmaniye State Hospital, Osmaniye, Turkey

A 55-year-old female patient was admitted to emergency service for hypotension and syncope. The patient was under dual antiplatelet therapy, aspirin, and prasugrel for coronary artery disease. Echocardiography revealed dilated right heart chambers as well as paradoxical septal motion, suggesting a diagnosis of pulmonary embolism. Thorax computerized tomography with contrast enhancement was performed and revealed thrombi in both main pulmonary arteries and their branches. Thrombolytic treatment was provided. There were no bleeding complications, and patient was discharged from the hospital on the seventh day, taking warfarin, clopidogrel, and aspirin. The present case is important because thrombolytic treatment for a patient who is on prasugrel has not been reported in the literature previously, and it illustrates that such therapy can be administered safely, though prasugrel has been associated with an increased rate of bleeding complications.

Keywords: Massive Pulmonary Embolism, Prasugrel, Thrombolytic Treatment


Prasugrel Kullanırken Trombolitik Tedavi Uygulanan Masif Pulmoner Emboli Olgusu

Ayşe Baha1, Reşat Mehmet Baha2, İbrahim Yıldız3
1Ufuk Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara
2Medicalpark Hastanesi, Kardiyoloji Kliniği, Ankara
3Osmaniye Devlet Hastanesi, Kardiyoloji Kliğini, Osmaniye

Elli beş yaşında, koroner arter hastalığı nedeni ile prasugrel ve asetilsalisilik asit kullanmakta olan kadın hasta, senkop ve hipotansiyon ile acile servise getirildi. Ekokardiyografide paradoks septum ve sağ ventrikülde genişleme saptanan, kontrastlı bilgisayarlı toraks tomografisinde bilateral ana pulmoner arterlerde ve dallarında yaygın trombüs görülen hastaya rt-PA uygulandı. Trombolitik bitiminde heparinize edilen hastanın tedavisine yirmi dördüncü saatte warfarin eklendi. Kanama komplikasyonu gelişmeyen hasta yedinci günde warfarin, klopidogrel, asetilsalisilikasit tedavileri altında taburcu edildi. Bu olgu, yeni kuşak antitrombotik olan presugrelin kanama riskinin yüksek olması, bu ilaç ile birlikte daha önce trombolitik kullanımının bildirilmemiş olması, sonuçta kanama komplikasyonu gelişmeden hastanın takip edilmesi açısından önemlidir.

Anahtar Kelimeler: Masif Pulmoner Emboli, Prasugrel, Trombolitik Tedavi


Ayşe Baha, Reşat Mehmet Baha, İbrahim Yıldız. Administration of Thrombolytic Treatment for Massive Pulmonary Embolism in A Patient on Prasugrel. Respir Case Rep. 2017; 6(3): 149-152

Corresponding Author: Ayşe Baha, Türkiye


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