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February 13, 2018Vascular and Endovascular Surgery

Ultrasound-Assisted Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism

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Why the study?

Does ultrasound-assisted catheter-directed thrombolysis improve right heart strain and pulmonary vascular obstruction safely in patients with submassive pulmonary embolism?

Population

30 consecutive patients with submassive pulmonary embolism, including those with risk factors for bleeding.

Design

Cohort

Follow-up

30-day

Authors

PMPrasoon P. MohanJMJohn ManovFCFrancisco Contreras

Discussion

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Overview

May support CDT for RV strain reduction in submassive PE without major bleeding; leaves open confirmation via randomized trials.

Structured PICO

Does ultrasound-assisted catheter-directed thrombolysis improve right heart strain and pulmonary vascular obstruction safely in patients with submassive pulmonary embolism?

P
Population
30 consecutive patients with submassive pulmonary embolism, including those with risk factors for bleeding (30% had ≥3 minor contraindications to thrombolysis, 47% had major surgery in the prior month).
I
Intervention
Ultrasound-assisted catheter-directed thrombolysis (CDT)
O
Outcome
Indicators of right heart strain (right ventricular systolic pressure, right ventricular dilation or hypokinesis) and degree of pulmonary vascular obstruction before and after CDTsurrogate

Ultrasound-assisted catheter-directed thrombolysis effectively reduces right heart strain and pulmonary vascular obstruction in submassive pulmonary embolism without causing major bleeding, even in patients with recent surgery.

Cite This Study

Mohan et al. (2018) studied this question.

synapsesocial.com/papers/6a198be9443d3ecd7cdebb58https://doi.org/10.1177/1538574418757400
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term benefit of thrombolytic therapy in patients with pulmonary embolism2000 · 110 citations
  2. 2Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension2011 · 2,241 citations
  3. 3Right Ventricular Dysfunction and Pulmonary Obstruction Index at Helical CT: Prediction of Clinical Outcome during 3-month Follow-up in Patients with Acute Pulmonary Embolism2005 · 503 citations
  4. 4Echocardiographic and functional cardiopulmonary problems 6 months after first-time pulmonary embolism in previously healthy patients2007 · 176 citations
  5. 5Health-related quality of life after pulmonary embolism: a cross-sectional study2016 · 94 citations