ACTIVASE (t-PA) FOR ACUTE MASSIVE PULMONARY EMBOLISM (AMPE)

  • Pulmonary Embolism remains common, underdiagnosed, and potentially lethal1
  • Acute Massive PE is defined as
    • – >50% occlusion of pulmonary vasculature2
    • – Unstable hemodynamics defined by failure to maintain BP without supportive measures
  • Activase (t-PA) is considered the standard treatment for patients with acute massive PE and is recommended by ACCP* & ACEP† Guidelines3
  • Early fibrinolysis with Activase (t-PA) may reduce the risk of PE recurrence and mortality in acute massive PE1,4,5
  • *
  • American College of Chest Physicians.
  • †
  • American College of Emergency Physicians.

For additional information regarding Activase (t-PA) and the treatment of acute massive PE, please see the resources listed below:

"Activase (t-PA) in Acute Massive Pulmonary Embolism" dosing card
  • "Activase® (t-PA) in Acute Massive Pulmonary Embolism" Dosing Card

  • "Fibrinolytics for Acute Massive Pulmonary Embolism" Educational CD-ROM

    How to download and extract ZIP files

    For PC users:

    • – Click on the link to the file and save it to your desktop
    • – Find the file and right-click. A menu will appear. Please select "WinZip"
    • – When WinZip opens, please select "extract all." Choose the folder to extract and click "OK"
    • – Once the files have been extracted, open the folder and select the extracted PowerPoint® files
    • – Note: For optimal viewing, press "F11" (which will hide all toolbars) followed by "F5" to refresh the screen

    For Mac users:

    • – Click on the link to the file and a menu will appear. Please choose "Save" and save to your desktop
    • – Find the file and double-click. Stuffit will unzip the files into a folder onto your desktop
    • – Open the folder and click the extracted PowerPoint® files to open

  • Download or order journal article
    Goldhaber SZ, Elliott CG. Acute pulmonary embolism: part I: epidemiology, pathophysiology, and diagnosis. Circulation. 2003;108:2726-2729.

  • Connect to guidelines from professional associations

Genentech is neither affiliated with nor endorses the organizations listed above.

Important Safety Information

Activase therapy in patients with pulmonary embolism is contraindicated in the following situations because of an increased risk of bleeding, which could result in significant disability or death:

  • Active internal bleeding
  • History of cerebrovascular accident
  • Recent intracranial or intraspinal surgery or trauma (see WARNINGS in full prescribing information)
  • Intracranial neoplasm, arteriovenous malformation, or aneurysm
  • Known bleeding diathesis
  • Severe uncontrolled hypertension

Indication: Activase (Alteplase) is indicated in the management of acute massive pulmonary embolism (PE) in adults: (1) for the lysis of acute pulmonary emboli, defined as obstruction of blood flow to a lobe or multiple segments of the lungs; (2) for the lysis of pulmonary emboli accompanied by unstable hemodynamics, e.g., failure to maintain blood pressure without supportive measures. The diagnosis should be confirmed by objective means, such as pulmonary angiography or noninvasive procedures such as lung scanning.

Safety Information: All thrombolytic agents increase the risk of bleeding, including intracranial bleeding. Not all patients will be eligible for Activase therapy, including those patients in the following situations, because of an increased risk of bleeding: active internal bleeding; history of cerebrovascular accident; recent intracranial or intraspinal surgery or trauma (see WARNINGS in full prescribing information); intracranial neoplasm, arteriovenous malformation, or aneurysm; known bleeding diathesis; or severe uncontrolled hypertension.


Please see full prescribing information.


References:
1.
Wood KE. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 2002;121:877-905.
2.
Tan KT, Oudkerk M, van Beek EJR. Deep vein thrombosis and pulmonary embolism. In: Hallet JW Jr, Mills JL, Earnshaw JJ, Reekers JA, eds. Comprehensive Vascular and Endovascular Surgery. Philadelphia, PA: Elsevier Limited; 2004:625-663.
3.
Kucher N, Goldhaber SZ. Management of massive pulmonary embolism. Circulation. 2005;112:e28-e32.
4.
Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet. 1993;341:507-511.
5.
Konstantinides S, Geibel A, Olschewski M, et al. Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. Circulation. 1997;96:882-888.
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