NON-IMMUNOGENIC STAPHYLOKINASE IN THE TREATMENT OF INTERMEDIATE–HIGH- RISK PULMONARY EMBOLISM
https://doi.org/10.52485/19986173_2026_2_218
Abstract
Intermediate–high-risk pulmonary embolism (PE) is characterized by preserved systemic hemodynamics in the presence of right ventricular (RV) dysfunction and elevated cardiac-specific biomarkers, which are associated with a risk of early clinical deterioration. The appropriateness of systemic thrombolytic therapy (TLT) in this patient population remains controversial, as it requires careful balancing of the potential reperfusion benefits against the risk of hemorrhagic complications. This review summarizes current evidence regarding anticoagulant therapy, systemic and catheter-directed reperfusion strategies, and discusses the potential role of non-immunogenic staphylokinase.
As a clinical illustration, we present a case of a patient with intermediate–high-risk PE who demonstrated clinical worsening despite anticoagulant therapy and was treated with systemic TLT using non-immunogenic staphylokinase, resulting in complete thrombus resolution, restoration of RV function, and absence of hemorrhagic complications. These findings highlight the need for further research to refine patient selection criteria and optimize treatment strategies.
About the Authors
B. S. Shaposhnikov
Stavropol State Medical University;
Izobilnenskaya District Hospital
Russian Federation
Russian Federation
Boris Sergeevich Shaposhnikov, Assistant of the Department of Pediatric Infectious Diseases
310 Mira St., Stavropol, Russia, 355017;
2 Kolkhoznaya St., Izobilny, Stavropol Territory, Russia, 356146
A. N. Obedin
Stavropol State Medical University
Russian Federation
Russian Federation
Alexander Nikolaevich Obedin, Doctor of Medical Sciences, Head of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira St., Stavropol, Russia, 355017
Yu. V. Bykov
Stavropol State Medical University;
Stavropol Regional Children's Clinical Hospital, 3
Russian Federation
Russian Federation
Yuri Vitalievich Bykov, Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology and Intensive Care with a course of additional professional education
310 Mira St., Stavropol, Russia, 355017;
3 Semashko St., Stavropol, Russia, 355002
E. V. Ushmudin
Izobilnenskaya District Hospital
Russian Federation
Russian Federation
Evgeny Valentinovich Ushmudin, anesthesiologist-resuscitator of the intensive Therapy, Anesthesiology and intensive Care
2 Kolkhoznaya St., Izobilny, Stavropol Territory, Russia, 356146
M. A. Teterina
Patrice Lumumba Peoples' Friendship University of Russia
Russian Federation
Russian Federation
Marina Alexandrovna Teterina, Assistant of the Department of Internal Medicine with a course in Cardiology and Functional Diagnostics named after Academician V.S. Moiseev
6 Miklukho-Maklaya St., Moscow, Russia, 117198
I. Merai
Patrice Lumumba Peoples' Friendship University of Russia;
V. V. Vinogradov University Clinical Hospital – branch of the Patrice Lumumba Peoples' Friendship University of Russia
Russian Federation
Russian Federation
Imad Merai, Professor of the Department of Internal Medicine with a course in Cardiology and Functional Diagnostics named after Academician V.S. Moiseeva, Head of the Intensive Care Unit for Cardiac Patients at the V.V. Vinogradov University Clinical Hospital
6 Miklukho-Maklaya St., Moscow, Russia, 117198;
61 Vavilov St., building 1 Moscow, Russia, 117292
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Review
For citations:
Shaposhnikov B.S., Obedin A.N., Bykov Yu.V., Ushmudin E.V., Teterina M.A., Merai I. NON-IMMUNOGENIC STAPHYLOKINASE IN THE TREATMENT OF INTERMEDIATE–HIGH- RISK PULMONARY EMBOLISM. Transbaikalian Medical Bulletin. 2026;(2):218-229. (In Russ.) https://doi.org/10.52485/19986173_2026_2_218
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