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Gabriel Thabut, MD; Damien Logeart, MD

Arch Intern Med. 2005;165:2204-2205.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The proponents of thrombolysis for patients with PE and RV dysfunction stress the high mortality rates of such patients without treatment and the well-proven hemodynamic benefit of thrombolysis in this setting. Conversely, the opponents emphasize the doubtful prognostic significance of RV dysfunction and the lack of evidence of clinical benefit and potentially life-threatening adverse effects of thrombolysis.

To move forward the debate, Goldhaber has long championed the implementation of a large international trial comparing thrombolysis and heparin in patients with acute PE and RV dysfunction.^1-2 At the same time, the proponents of this treatment stress the difficulties in launching such a large-scale trial; the largest randomized controlled trial with published results to date included only 256 patients. Funding support and recruitment difficulties are the 2 arguments commonly used against launching a large-scale trial.³

French investigators plan to launch a multicenter trial comparing thrombolysis and . . . [Full Text of this Article]

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