Navigation

Individual research recommendation details

Recommendation details

Recommendation ID: CG144/5
Question: Systemic pharmacological thrombolysis compared with standard anticoagulation treatment in patients with pulmonary embolism and right ventricular dysfunction:- What is the clinical and cost effectiveness of systemic pharmacological thrombolysis compared with standard initial anticoagulation therapy in patients with confirmed PE and haemodynamic stability who present with right ventricular dysfunction?
Page: 28
Any explanatory
notes (if applicable):
Why this is important:- It is unclear from the evidence identified in the review whether there are subgroups of patients with PE and haemodynamic stability who have a significant risk of PE-related mortality and morbidity and who would benefit from systemic thrombolysis. No evidence was found in the clinical review for the safety and effectiveness of pharmacological thrombolysis in patients with confirmed PE and haemodynamic stability who present with right ventricular dysfunction. An RCT is needed to compare pharmacological thrombolysis (for example, with alteplase) with standard initial anticoagulation therapy (with LMWH or fondaparinux) in these patients. The important outcomes would be all-cause mortality, VTE-related mortality, cardiopulmonary resuscitation, major bleeding, VTE recurrence and chronic thromboembolic pulmonary hypertension. This research could improve early outcomes and survival, and reduce complications such as chronic thromboembolic pulmonary hypertension, and would inform an update of this guideline. Currently the guideline does not recommend systemic thrombolysis for these patients.

Source guidance details

Comes from guidance: Venous thromboembolic diseases
Number: CG144
Date issued: Jun 2012

Research needed into:

Effectiveness of treatment: No
Cost of treatment: No
Implementation of treatment: No
Quality of life: No
Methods of research: No

Other details

Is this a recommendation for the use of a technology only in the context of research?: No
Is it a recommendation that suggests collection of data or the establishment of a register?: No
Recommendation priority: Unrated
Recommendation status: Research Pending
Notes: 0
Date this record updated: 10-07-2012

Links and updates

This page was last updated: 20 March 2014

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.