Ultrasound-assisted catheter-directed thrombolysis compared with anticoagulation alone for treatment of intermediate-risk pulmonary embolism

Pulmonary Circulation
Andrew J SchisslerAaron B Waxman

Abstract

It is unclear if ultrasound-assisted catheter-directed thrombolysis (UACDT) confers benefit over anticoagulation (AC) alone in the management of intermediate-risk ("submassive") pulmonary embolism (PE), defined by evidence of right ventricular (RV) dysfunction in hemodynamically stable patients. This study sought to evaluate any lasting advantage of UACDT on mortality and resolution of RV dysfunction in intermediate-risk PE at a large academic medical center. Adults aged ≤ 86 years admitted with intermediate-risk PE from 2011 to 2016 were retrospectively identified. Patients were excluded if there was a history of cancer, pre-existing pulmonary hypertension, pregnancy or postpartum status, contraindication to AC, or treatment with systemic thrombolysis. Baseline Pulmonary Embolism Severity Index (PESI) scores were computed. Outcomes including length of stay (LOS), bleeding complications, resolution of RV dysfunction, and mortality were compared between patients who received UACDT and those managed with AC alone. A total of 104 patients met inclusion criteria, 65 of whom underwent UACDT. The cohorts had similar PESI scores ( P = 0.45) and no clearly imbalanced confounding variables. There was no significant difference in LOS ( P...Continue Reading

References

Sep 2, 1993·The New England Journal of Medicine·UNKNOWN GUSTO investigators
Jul 2, 2010·The New England Journal of Medicine·Giancarlo Agnelli, Cecilia Becattini
Mar 23, 2011·Circulation·Michael R JaffUNKNOWN American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology
Apr 13, 2012·Lancet·Samuel Z Goldhaber, Henri Bounameaux
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
Feb 24, 2015·Journal of Vascular and Interventional Radiology : JVIR·Sandeep BaglaKeith M Sterling
Jan 19, 2016·Journal of Thrombosis and Thrombolysis·Alok A KhoranaAgnes Y Y Lee
Feb 27, 2016·Journal of the American College of Cardiology·Stavros V KonstantinidesGuy Meyer
Mar 20, 2016·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Madeline NykampChad Laurich
Jul 9, 2016·Therapeutics and Clinical Risk Management·Bülent AltınsoyMeltem Tor
Mar 25, 2017·Journal of the American College of Cardiology·Stavros V KonstantinidesGuy Meyer

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Citations

Oct 13, 2020·Current Cardiovascular Risk Reports·Connor TiceTaisei Kobayashi
Mar 14, 2020·Ultrasound in Medicine & Biology·Klazina KooimanChristy K Holland
Mar 6, 2021·Journal of Thrombosis and Thrombolysis·Mauricio Castillo-PerezMauricio Vazquez-Guajardo
Jun 5, 2021·Current Cardiology Reviews·Juan Arturo Siordia, Amanpreet Kaur

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