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Streptokinase (290 000 U/2 h) was directly infused under angiographic control into the predominantly affected right pulmonary artery in a 71-year-old patient with acute pulmonary embolism and persistent shock. This led to immediate complete remission of shock symptoms and lasting stabilisation of the patient. If, as this case demonstrates, embolectomy is not possible and high-dose intravenous streptokinase is contraindicated, localised use of streptokinase in low dosage offers a possibility for treatment of life-threatening pulmonary embolism.
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