UPET 197020 | | IV heparin v UK | | 78 | | 7 (8.9) | | 15 (19) | | 21 (27) | | Patients had <5 days of symptoms |
| 2000 U/lb bolus then hourly | | 82 | | 6 (7.3) | | 12 (15) | | 37 (45) | | Angiography used to diagnose and repeated at 24 hours showing improved haemodynamics in UK group |
Tibbutt et al 197421 | | IP heparin | | 17 | | 1 (5.8) | | 1 (5.8) | | 1 (5.8) | | SK group had greater improvement in pulmonary perfusion |
| IP SK 600 000 units bolus then 100 000 units/h for 72 hours | | 13 | | 0 | | 0 | | 1 (8) | | All patients had life threatening PE and angiographic diagnosis |
Ly et al 197822 | | IV heparin v APTT | | 11 | | 2 (18.2) | | NA | | 2 (18) | | Angiographic evidence of improved perfusion with SK |
| SK 250000 units bolus and 100000 units per hour 72 hours | | 14 | | 1 (7.1) | | | | 4 (29) | | All patients >1 lobar artery occluded |
Marini et al 198823 | | Heparin v APTT | | 10 | | 0 | | 0 | | 0 | | Patients all >9 segments not perfused on Q scan. By 24 hrs and at 1 year no difference in pulmonary haemodynamics |
| UK 800 000 units 12 hourly for 3 days | | 10 | | 0 | | 0 | | 0 | | |
| UK 3 300 000 units for 12 hours | | 10 | | 0 | | 0 | | 0 | | |
PIOPED 199024 | | Heparin v APTT | | 4 | | 0 | | NA | | 0 | | Vascular resistance better for rTPA group at 90 mins but equal at 2 hrs |
| rTPA 40–80 mg for 40–90 minutes | | 9 | | 1 (11.1) | | | | 1 (11.1) | | Patient diagnosis by angiogram |
Levine et al 199025 | | Heparin v APTT | | 25 | | 0 | | 0 | | 0 | | Perfusion scan on day 1 better with rTPA but equal by day 7 |
| rTPA 0.6 mg/kg over 2 minutes | | 33 | | 1 (3) | | 0 | | 0 | | Diagnosis by angiogram |
PAIMS 2 199226 | | Heparin v APTT | | 16 | | 1 (6.3) | | 3 (18.8) | | 2 (12.5) | | Haemodynamics better at 24 hours in rTPA group but equal day 7 and 30 |
| rTPA 100 mg over 2 hours | | 20 | | 2 (10) | | 1 (5) | | 3 (15) | | |
Goldhaber et al 199327 | | Heparin v APTT | | 55 | | 2 (3.6) | | 5 (9.1) | | 1 (1.8) | | Perfusion scans and RV function on echo better in rTPA at 24 hours |
| rTPA 100 mg over 2 hours | | 46 | | 0 | | 0 | | 2 (4.3) | | |
Jerges-Sanches et al 199528 | | Heparin infusion v APTT | | 4 | | 4 (100) | | NA | | 0 | | All patients had shock. 100% mortality in heparin group led to trial being abandoned early |
| SK 1 500 000 units over 1 hour | | 4 | | 0 | | | | 0 | | |
Konstantinides et al 200229 | | Heparin infusion v APTT | | 138 | | 3 (2.2) | | 4 (2.9) | | 5 (3.6) | | Unexpectedly low mortality. Composite end point of death or treatment escalation lower in rTPA |
| rTPA 100 mg over 2 hours | | 118 | | 4 (3.4) | | 4 (3.4) | | 1 (0.8) | | Group: see text. |