Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma

Aim. To evaluate the safety and efficacy of the non-immunogenic staphylokinase in a patient with a massive high-risk pulmonary embolism (PE) with subdural hematoma.Material and methods. Non-immunogenic staphylokinase (Fortelyzin®, LLC “SuperGene”, Russia) is an original thrombolytic drug with high f...

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Main Authors: S. L. Konstantinov, Zh. Yu. Chefranova, G. I. Stryabkova, S. A. Pribylov, I. B. Kovalenko, E. V. Gavrilyuk, S. V. Ivanov, S. S. Markin
Format: Article
Language:English
Published: Столичная издательская компания 2025-08-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/3185
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author S. L. Konstantinov
Zh. Yu. Chefranova
G. I. Stryabkova
S. A. Pribylov
I. B. Kovalenko
E. V. Gavrilyuk
S. V. Ivanov
S. S. Markin
author_facet S. L. Konstantinov
Zh. Yu. Chefranova
G. I. Stryabkova
S. A. Pribylov
I. B. Kovalenko
E. V. Gavrilyuk
S. V. Ivanov
S. S. Markin
author_sort S. L. Konstantinov
collection DOAJ
description Aim. To evaluate the safety and efficacy of the non-immunogenic staphylokinase in a patient with a massive high-risk pulmonary embolism (PE) with subdural hematoma.Material and methods. Non-immunogenic staphylokinase (Fortelyzin®, LLC “SuperGene”, Russia) is an original thrombolytic drug with high fibrin selectivity and minimal risk of bleeding. A clinical case of the non-immunogenic staphylokinase usage at a dose of 15 mg as a single bolus in an elderly patient with massive high-risk PE with subdural hematoma is presented.Results. Thrombolytic therapy with the non-immunogenic staphylokinase was performed in an 85-years old female with very high mortality risk PE (PESI class V) associated with acute subdural lamellar hematoma, resulting from closed craniocerebral injury. In the first day after thrombolytic therapy, a decrease dyspnea, increase saturation from 74% to 97%, decrease pulmonary artery pressure from 60 to 31 mm Hg, and reduce of right ventricular dysfunction were noted. According to brain CT, on the first day after thrombolysis, an increase in the volume of the subdural hematoma (maximum thickness 8 mm) without dislocation syndrome and without focal neurological deficit was registered. After one week, the patient was discharged. At the follow-up examination after 4 months, regression of the subdural hematoma was noted (the thickness less than 2 mm). The non-immunogenic staphylokinase usage did not lead to major bleeding and hemorrhagic stroke.Conclusion. The non-immunogenic staphylokinase has shown safety and efficacy in massive PE treatment in an elderly patient with high hemorrhagic risk due to a subdural hematoma.
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institution Kabale University
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spelling doaj-art-099ab40e52354e6ebbce4bfd993684522025-08-23T10:00:37ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532025-08-0121327528010.20996/1819-6446-2025-31852293Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematomaS. L. Konstantinov0Zh. Yu. Chefranova1G. I. Stryabkova2S. A. Pribylov3I. B. Kovalenko4E. V. Gavrilyuk5S. V. Ivanov6S. S. Markin7Belgorod Regional Clinical Hospital of St. JosephBelgorod State UniversityBelgorod Regional Clinical Hospital of St. JosephBelgorod Regional Clinical Hospital of St. Joseph ; Kursk State Medical UniversityBelgorod Regional Clinical Hospital of St. JosephKursk State Medical UniversityV. N. Orekhovich Research Institute of Biomedical ChemistryV. N. Orekhovich Research Institute of Biomedical ChemistryAim. To evaluate the safety and efficacy of the non-immunogenic staphylokinase in a patient with a massive high-risk pulmonary embolism (PE) with subdural hematoma.Material and methods. Non-immunogenic staphylokinase (Fortelyzin®, LLC “SuperGene”, Russia) is an original thrombolytic drug with high fibrin selectivity and minimal risk of bleeding. A clinical case of the non-immunogenic staphylokinase usage at a dose of 15 mg as a single bolus in an elderly patient with massive high-risk PE with subdural hematoma is presented.Results. Thrombolytic therapy with the non-immunogenic staphylokinase was performed in an 85-years old female with very high mortality risk PE (PESI class V) associated with acute subdural lamellar hematoma, resulting from closed craniocerebral injury. In the first day after thrombolytic therapy, a decrease dyspnea, increase saturation from 74% to 97%, decrease pulmonary artery pressure from 60 to 31 mm Hg, and reduce of right ventricular dysfunction were noted. According to brain CT, on the first day after thrombolysis, an increase in the volume of the subdural hematoma (maximum thickness 8 mm) without dislocation syndrome and without focal neurological deficit was registered. After one week, the patient was discharged. At the follow-up examination after 4 months, regression of the subdural hematoma was noted (the thickness less than 2 mm). The non-immunogenic staphylokinase usage did not lead to major bleeding and hemorrhagic stroke.Conclusion. The non-immunogenic staphylokinase has shown safety and efficacy in massive PE treatment in an elderly patient with high hemorrhagic risk due to a subdural hematoma.https://www.rpcardio.online/jour/article/view/3185non-immunogenic staphylokinasepulmonary embolismhematomableeding riskthrombolytic therapyelderly patientssafety outcomeshemorrhagic complications
spellingShingle S. L. Konstantinov
Zh. Yu. Chefranova
G. I. Stryabkova
S. A. Pribylov
I. B. Kovalenko
E. V. Gavrilyuk
S. V. Ivanov
S. S. Markin
Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
Рациональная фармакотерапия в кардиологии
non-immunogenic staphylokinase
pulmonary embolism
hematoma
bleeding risk
thrombolytic therapy
elderly patients
safety outcomes
hemorrhagic complications
title Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
title_full Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
title_fullStr Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
title_full_unstemmed Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
title_short Non-immunogenic staphylokinase in the high-risk pulmonary embolism treatment with subdural hematoma
title_sort non immunogenic staphylokinase in the high risk pulmonary embolism treatment with subdural hematoma
topic non-immunogenic staphylokinase
pulmonary embolism
hematoma
bleeding risk
thrombolytic therapy
elderly patients
safety outcomes
hemorrhagic complications
url https://www.rpcardio.online/jour/article/view/3185
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