• David Pillus, Eric Bruno, David Farcy, Gary M Vilke, and Richard Childers.
• Department of Emergency Medicine, University of Tennessee, Nashville, Tennessee.
• J Emerg Med. 2019 Oct 1; 57 (4): 517-522.

BackgroundThis systemic review provides practicing emergency physicians updated information about the role of thrombolysis in the treatment of intermediate-risk pulmonary embolism.MethodsA PubMed literature search from January 1, 2005 to December 31, 2018 was conducted and limited to human clinical trials written in English with relevant keywords. High-quality studies were identified and then underwent a structured review. Recommendations are made based on the literature review.ResultsSixty-three articles met criteria for rigorous review, of which 13 were appropriate for citation in this review. Of these 13, there were 6 prospective studies and 7 retrospective studies.ConclusionsThrombolysis, either catheter-directed or systemic, is a treatment option in the management of patients with intermediate-risk pulmonary embolism and a high likelihood of clinical deterioration. Each method of thrombolysis carries risks and benefits. Based on the available evidence, transfer to a facility for the purpose of catheter-directed thrombolysis is not recommended.Copyright © 2019 Elsevier Inc. All rights reserved.

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