This is a retrospective study documenting the use of
tenecteplase in 41 cases of suspected or confirmed
pulmonary embolism receiving in-hospital
tenecteplase as per weight-adjusted dosing in addition to standard
heparin and oral
anticoagulant therapy. The presenting symptoms of dyspnoea,
chest pain,
hemoptysis and
syncope were found in 40 (97.56%), 19 (46.34%), 6 (14.63%) and 9 (21.95%) patients, respectively. There was one case of mortality who was a 26 yrs old female of postpartum pulmonary thrombo-
embolism with severe
hypotension,
cyanosis, bilateral crepitations in lungs and
pulmonary hypertension. In the 40 survived patients, there was alleviation of dyspnoea and
hemoptysis in all patients. Significant reduction in
tachycardia (P < 0.0001) and increase in the oxygen saturation (SaO₂) (P < 0.0001) were seen at discharge as compared to at the time of presentation. Eighteen patients had
hypotension which recovered in all patients till the time of discharge (P < 0.0001). There was a significant reduction in right ventricular systolic pressure in all 18 patients who underwent 2-D echocardiography both before and after the
tenecteplase therapy. Resolution of
pulmonary embolism on CT pulmonary angiography was documented in only two patients. No
bleeding events or any other adverse events were reported during this study. The present study suggests favourable efficacy of
tenecteplase in patients with suspected or confirmed acute
pulmonary embolism. Although no major adverse events were noted, a large prospective study on the use of
tenecteplase in
pulmonary embolism is suggested.