タジマ　ヒロユキ   TAJIMA Hiroyuki   田島　廣之    所属   埼玉医科大学  医学部 国際医療センター　放射線科（放射線腫瘍科、画像診断、核医学科）    職種   特任教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Thrombolysis With a Novel Modified Tissue-Type Plasminogen Activator, Monteplase, Combined With Catheter-Based Treatment for Major Pulmonary Embolism
掲載誌名	正式名：CIRCULATION JOURNAL ISSNコード：13469843
出版社	JAPANESE CIRCULATION SOC
巻・号・頁	73(1),106-110頁
著者・共著者	Takeshi Yamamoto,Koji Murai,Yukichi Tokita,Koji Kato,Yu-Ki Iwasaki,Naoki Sato,Hiroyuki Tajima,Kyoichi Mizuno,Keiji Tanaka
発行年月	2009/01
概要	Background A novel modified tissue-type plasminogen activator, monteplase, has been approved for acute major pulmonary embolism (PE) in Japan. Monteplase has rapid and sustained lytic effects because of a steep rise in concentration after bolus infusion and a longer half-life.Methods and Results To assess the efficacy and safety of thrombolysis with monteplase in combination with catheter-based treatment, acute hemodynamic changes and clinical outcomes were assessed in 50 patients with angiographically confirmed major PE. Thrombolysis with monteplase in combination with embolus fragmentation and thrombectomy was the acute phase treatment. The study population comprised 31 females and 19 males (mean age 62 years). All patients had right ventricular (RV) overload; 12 patients presented in shock. The mean pulmonary artery pressure decreased significantly from 32 +/- 9 mmHg to 25 +/- 6 mmHg after acute phase treatment (P<0.0001). The mean dosage of monteplase was 12,265 IU/kg. Death at 30 days occurred in 3 patients (6%). Major bleeding occurred in 12 patients (24%). RV overload at discharge remained in only 3% of the patients with typically acute onset.Conclusions Thrombolysis wi
DOI	10.1253/circj.CJ-08-0660
NAID	110007007959