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Letters |15 April 1995

Risks for Bleeding in Patients with Pulmonary Embolism Treated with Thrombolytic Agents

Bimal P. Jain

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TO THE EDITOR:
I suggest that only major bleeding at catheter insertion sites and not at other sites, such as intracerebral or retroperitoneal sites, be considered a complication of pulmonary angiography in patients receiving thrombolytic therapy. The reported risk for this complication would therefore be 10.6% (7 of 66 patients) and not 14% (18 of 129 patients) as calculated by Stein and colleagues [1]. To avoid this complication, they recommend giving thrombolytic therapy without pulmonary angiography if the calculated frequency (probability) of pulmonary embolism from clinical and lung scan evaluation is higher than 21%. I find this recommendation clinically unacceptable, as shown by the following example.
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Jain BP. Risks for Bleeding in Patients with Pulmonary Embolism Treated with Thrombolytic Agents. Ann Intern Med. ;122:630–632. doi: 10.7326/0003-4819-122-8-199504150-00018

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Published: Ann Intern Med. 1995;122(8):630-632.

DOI: 10.7326/0003-4819-122-8-199504150-00018

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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