Key result
Thrombolysis fails to reduce 90-day mortality in massive PE, while IVC filters show lower mortality.
Why the study?
Does thrombolysis or IVC filter placement reduce mortality or recurrent pulmonary embolism at 90 days in patients with massive pulmonary embolism?
Does thrombolysis or IVC filter placement reduce mortality or recurrent pulmonary embolism at 90 days in patients with massive pulmonary embolism?
In the ICOPER registry of massive pulmonary embolism, thrombolysis was not associated with reduced 90-day mortality or recurrent PE, whereas IVC filters showed an observed mortality reduction warranting further study.
Should not yet change practice in massive PE; leaves open efficacy of thrombolysis and IVC filters for randomized trials.
In ICOPER, two thirds of the patients with massive PE did not receive thrombolysis or embolectomy. Counterintuitively, thrombolysis did not reduce mortality or recurrent PE at 90 days. The observed reduction in mortality from IVC filters requires further investigation.
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Kucher et al. (2006) studied this question. Thrombolysis did not reduce 90-day mortality or recurrent pulmonary embolism in patients with massive pulmonary embolism, while inferior vena cava filters were associated with lower mortality.
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