Thrombolytic therapy in venous thromboembolism. Clinical trials and current indications.

Thrombolytic therapy for venous thromboembolism is returning, especially for the management of acute pulmonary embolism patients who present with either hypotension or with right ventricular dysfunction despite an initially normal blood pressure and heart rate. Clinicians have learned to use thrombolysis to improve efficacy, minimize bleeding complications, and achieve savings in cost. The objective of therapy is rapid reversal of right ventricular dysfunction, which might otherwise lead to intractable right ventricular failure and death.