Background: Pulmonary reperfusion in acute pulmonary embolism (PE) by using a fixed full dose regimen of 100 mg of recombinant tissue-type plasminogen activator (rt-PA) over 2 hours or an accelerated low-dose rt-PAregimen has not only been controversial in Vietnam.

Aims: To describe the outcomes of an accelerated low-dose rt-PA regimen for the treatment of high to intermediate mortality risk PE in Vietnamese patients.

Methods: This was a case series study, the PE patients of high to intermediate mortality risk were enrolled in ninedifferent hospitals across Vietnam. The selected PE patients received an injection alteplase with the dosage of 0.6 mg per kilogram of body weight (maximum of 50mg) over 15 minutes. The main outcome of study was the survival rate at hospital discharge and at three months post discharge; in-hospital haemorrhage.

Results: A total of 80 patients were enrolled in this study. There were 48 patients (60%) with high-risk mortality PE and 32 patients (40%) classified as intermediate risk mortality PE. Seven patients (8.75%) had died at the time of hospital discharge and all of these were classified in the high-risk mortality group. All 73 patients who were alive at discharge were alive after 3 months follow up. There were 1 patient (1.25%) of major bleeding and 7 (8.75%) of minor bleeding.

Conclusions: Accelerated regimen with 0.6mg per kilogram of body weight over 15 minutes of alteplase was initiallyeffective and safe on Vietnamese patients with acute pulmonary embolism after 3 months follow up.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-accelerated-regimen-of-low-dose-recombinant-tissue-type-plasminogen-for-the-treatment-of-acute-pulmonary-embolism-a-case-series-from-vietnam/