A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study.

JACC. Cardiovascular Interventions
Gregory PiazzaSEATTLE II Investigators

Abstract

This study conducted a prospective, single-arm, multicenter trial to evaluate the safety and efficacy of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis, using the EkoSonic Endovascular System (EKOS, Bothell, Washington). Systemic fibrinolysis for acute pulmonary embolism (PE) reduces cardiovascular collapse but causes hemorrhagic stroke at a rate exceeding 2%. Eligible patients had a proximal PE and a right ventricular (RV)-to-left ventricular (LV) diameter ratio ≥0.9 on chest computed tomography (CT). We included 150 patients with acute massive (n = 31) or submassive (n = 119) PE. We used 24 mg of tissue-plasminogen activator (t-PA) administered either as 1 mg/h for 24 h with a unilateral catheter or 1 mg/h/catheter for 12 h with bilateral catheters. The primary safety outcome was major bleeding within 72 h of procedure initiation. The primary efficacy outcome was the change in the chest CT-measured RV/LV diameter ratio within 48 h of procedure initiation. Mean RV/LV diameter ratio decreased from baseline to 48 h post-procedure (1.55 vs. 1.13; mean difference, -0.42; p < 0.0001). Mean pulmonary artery systolic pressure (51.4 mm Hg vs. 36.9 mm Hg; p < 0.0001) and modified Miller Index score (22.5 vs. 15.8; p <...Continue Reading

References

Sep 2, 1993·The New England Journal of Medicine·UNKNOWN GUSTO investigators
Jul 13, 2005·Circulation·Nils Kucher, Samuel Z Goldhaber
Dec 27, 2005·The American Journal of Cardiology·Karen FiumaraSamuel Z Goldhaber
Nov 21, 2007·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Samuel Z Goldhaber
Oct 31, 2009·Journal of Vascular and Interventional Radiology : JVIR·William T KuoLawrence V Hofmann
Dec 23, 2009·Journal of Thrombosis and Haemostasis : JTH·F A KlokM V Huisman
Sep 15, 2010·Circulation·Gregory Piazza, Samuel Z Goldhaber
Mar 23, 2011·Circulation·Michael R JaffUNKNOWN American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology
Feb 14, 2012·The American Journal of Medicine·Paul D Stein, Fadi Matta
Oct 30, 2012·The American Journal of Cardiology·Mohsen SharifiMahshid Mehdipour
Jan 10, 2013·JAMA : the Journal of the American Medical Association·Gregory Piazza
Apr 11, 2014·The New England Journal of Medicine·Guy MeyerUNKNOWN PEITHO Investigators
Jun 12, 2014·European Heart Journal·Christophe MartiArnaud Perrier
Jun 19, 2014·JAMA : the Journal of the American Medical Association·Saurav ChatterjeeJay Giri
Sep 1, 2014·European Heart Journal·Stavros V KonstantinidesUNKNOWN Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
Jan 17, 2015·Circulation. Cardiovascular Interventions·Rolf P EngelbergerNils Kucher
Feb 15, 2015·The American Journal of Medicine·Felix G MeinelFabian Bamberg

❮ Previous
Next ❯

Citations

Feb 13, 2016·Journal of Interventional Cardiology·Derek C WhiteTheodore L Schreiber
Feb 3, 2016·The American Journal of Cardiology·Ashraf MostafaCindy Grines
Dec 4, 2015·Thrombosis and Haemostasis·Stavros V Konstantinides
Jan 19, 2016·Journal of Thrombosis and Thrombolysis·Suresh VedanthamNeil A Goldenberg
Mar 1, 2016·Current Treatment Options in Cardiovascular Medicine·Mohsen Sharifi
Aug 15, 2015·Cardiology in Review·Rishi K Wadhera, Gregory Piazza
Apr 25, 2016·The American Journal of Cardiology·Adham N Abou AliEfthymios D Avgerinos
Jan 31, 2015·The American Journal of Cardiology·James M McCabePiotr Sobieszczyk
May 29, 2016·The American Journal of Emergency Medicine·Dario BuccheriGiuseppe Andolina
Oct 27, 2016·Heart, Lung & Circulation·J J EdelmanJ Passage
Jun 12, 2016·Journal of Vascular and Interventional Radiology : JVIR·Akhilesh K SistaClive Kearon
Oct 25, 2016·The Annals of Thoracic Surgery·W Brent KeelingUNKNOWN SPEAR Working Group
Oct 9, 2016·International Journal of Cardiology·Navkaranbir S BajajMustafa I Ahmed
Sep 27, 2016·Annals of Vascular Surgery·Timothy J FullerPatrick E Muck
Feb 2, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Tyler L BloomerWissam A Jaber
Dec 4, 2016·Vascular Medicine·Immad SadiqUNKNOWN Submassive and Massive Pulmonary Embolism Treatment with Ultrasound AcceleraTed ThromboLysis ThErapy (SEATTLE II) Investigat
Feb 23, 2017·AJR. American Journal of Roentgenology·Harish Jarrett, Riyaz Bashir
Mar 28, 2017·Journal of Vascular and Interventional Radiology : JVIR·Chirag A ChauhanCatalin Toma
Mar 23, 2017·Hospital Practice·Geoffrey BarnesUNKNOWN National PERT™ Consortium Research Committee
Apr 13, 2017·Journal of Thrombosis and Thrombolysis·Maya SerhalJohn R Bartholomew
Jun 3, 2017·Expert Review of Cardiovascular Therapy·Emily K ZernChristopher Kabrhel
May 26, 2017·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·John R SprattMichael S Rosenberg
Jun 9, 2017·Thrombosis and Haemostasis·Sam SchulmanStavros V Konstantinides
Jan 20, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Neal Kumar BhatiaVasilis Babaliaros
Apr 12, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Sarju GanatraMichael S Levy
Nov 15, 2015·Vascular Medicine·Akhilesh K SistaSamuel Z Goldhaber
Feb 13, 2016·Therapeutic Advances in Cardiovascular Disease·Mohamed TelebDebabrata Mukherjee
Sep 8, 2016·Journal of Intensive Care Medicine·Aaron Samuel WeinbergVictor F Tapson
Dec 9, 2017·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Chetan PasrijaZachary N Kon
Feb 14, 2018·Vascular and Endovascular Surgery·Prasoon P MohanGovindarajan Narayanan
Aug 11, 2017·World Journal of Radiology·Miguel A De GregorioWilliam T Kuo
Aug 25, 2017·Hospital Practice·Mitchell D JacobsMichael L Scharf
Sep 28, 2017·Asian Cardiovascular & Thoracic Annals·Wing Hang LukJohnny Ka Fai Ma

❮ Previous
Next ❯

Related Concepts

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.