Non-immunogenic staphylokinase in the treatment of high-risk massive pulmonary embolism in the early postoperative period due to femoral fragment wound

A case report of double thrombolytic therapy with non-immunogenic staphylokinase at a dose of 15 mg bolus over 15 s in a patient with a high-risk massive pulmonary embolism (PE) in the early postoperative period due to femoral wound is described. After the second thrombolysis, a decrease in the pulmonary arteries thrombotic lesions according to multislice computed tomography data, restoration of right ventricular function, and a decrease in pulmonary hypertension were observed. Reuse of the non-immunogenic staphylokinase did not lead to the major bleeding and hemorrhagic stroke, did not provoke a drop in hemoglobin and did not require blood transfusion. Upon discharge of the patient, normalization of the general blood test parameters was noted: the level of hemoglobin increased from 86 to 112 g/l, erythrocytes — from 2.8 to 3.5x1012/l, hematocrit — from 26 to 32%. Thus, non-immunogenic staphylokinase has demonstrated high efficacy and safety in the treatment of patient with a high-risk massive PE in the early postoperative period.