
A multicenter retrospective study comparing outcomes in pulmonary embolism (PE) patients treated with full-dose (100mg) vs. reduced-dose (50mg) alteplase found both regimens led to improved hemodynamic variables. Reduced doses showed lower hemorrhagic complications (13% vs. 24.5%, p=0.014), predominantly minor, and fewer major extracranial hemorrhages (1.1% vs. 6.1%, p=0.022). Complications were linked to supratherapeutic heparin and invasive procedures. Post-propensity score weighting, differences in complications persisted but were not statistically significant. Mortality, discharge, ICU/hospital length of stay, and readmission showed no significant differences. The study suggests considering reduced-dose alteplase for PE with cautious anticoagulation and procedure management to minimize complications.
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