[Comparison of efficacy and tolerability of a thrombolytic treatment with rt-PA in acute massive pulmonary embolism in the elderly and patients under 75 years of age]

Rev Med Interne. 1997 Jul;18(7):521-7. doi: 10.1016/s0248-8663(97)80803-x.
[Article in French]


Background: Pulmonary embolism often occurs in elderly patients. However, clinical presentation and treatment of massive pulmonary embolism (PE) in the elderly have not been extensively investigated. We report the results of rt-PA bolus infusion in patients aged 75 years or more suffering from massive PE.

Methods: Fifty-four adult patients referred to our institution with symptoms suggestive of massive PE were included in a therapeutic trial of single-chain rt-PA. Patients with a Miller angiographic score of at least 20/34 were considered for entry into the study. Patients were divided into two groups according to their age. Clinical presentation at admission, resolution of scintigraphic vascular obstruction, death rate, hemorrhagic complications, recurrent pulmonary embolism and long-term follow-up were compared between both groups.

Results: Twenty-eight patients were less than 75 years old and 26 patients were aged 75 years or more. Clinical symptoms at admission were similar in both groups. The mean absolute improvement in the lung scan perfusion defect, the rate of major bleeding, and the long-term evolution were not statistically different between older and younger patients.

Conclusion: Clinical presentation and tolerance of massive PE did not differ between elderly and non-elderly patients. Old age should not preclude thrombolytic therapy in massive PE, provided there are no other contraindications for thrombolytic treatment.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Aged
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Plasminogen Activators / adverse effects
  • Plasminogen Activators / therapeutic use*
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / mortality
  • Risk Factors
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / adverse effects
  • Tissue Plasminogen Activator / therapeutic use*


  • Plasminogen Activators
  • Tissue Plasminogen Activator