What is the clinical evidence from this study?

Study design: Case Report. Population: Dyspnea and presumed submassive pulmonary embolism (n=1). Intervention: Catheter-directed embolectomy and thrombolysis. Primary outcome: Clinical or radiographic improvement.

What question did this study set out to answer?

To describe the clinical evaluation and treatment response of an elderly woman presenting with progressive dyspnea and a persistent pulmonary artery filling defect.

May 21, 2015JAMA OncologyOpen Access

An Elderly Woman With Dyspnea

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Key result

Catheter-directed embolectomy and thrombolysis for a presumed submassive pulmonary embolism resulted in no substantial clinical or radiographic improvement in 1 patient.

Key Points

To describe the clinical evaluation and treatment response of an elderly woman presenting with progressive dyspnea and a persistent pulmonary artery filling defect.
Clinical and diagnostic evaluation of a woman in her 70s with a history of venous thromboembolism who presented with 2 months of progressive exertional dyspnea while on warfarin anticoagulation (INR 2.8).
Assessment via chest computed tomography (CT), transthoracic echocardiography, and subsequent urgent catheter-directed embolectomy and thrombolysis for presumed submassive pulmonary embolism.
Initial CT imaging revealed a large filling defect in the main pulmonary artery, interventricular septal flattening, and multiple pulmonary nodules.
Transthoracic echocardiography confirmed severe right ventricular systolic hypertension with moderate right ventricular dilation.
Urgent pharmacomechanical embolectomy and catheter-directed thrombolysis produced no substantial clinical or radiographic improvement on repeat chest CT.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A woman in her 70s with a history of venous thromboembolism presenting with progressively worsening dyspnea on exertion.

Intervention

Catheter-directed embolectomy and thrombolysis

Outcome

Clinical and radiographic improvement

This case highlights a clinical scenario where a presumed submassive pulmonary embolism did not respond to pharmacomechanical interventions, prompting further diagnostic evaluation.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

One negative case does not inform practice; leaves open the efficacy of catheter-directed interventions for submassive PE.

Cite This Study

O’Connor et al. (2015) conducted a case report in Dyspnea and presumed submassive pulmonary embolism (n=1). Catheter-directed embolectomy and thrombolysis was evaluated on Clinical or radiographic improvement. Catheter-directed embolectomy and thrombolysis for a presumed submassive pulmonary embolism resulted in no substantial clinical or radiographic improvement in 1 patient.

synapsesocial.com/papers/6a6f44318031ec7bb1dbaca4 https://doi.org/10.1001/jamaoncol.2015.1169

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An Elderly Woman With Dyspnea

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

An Elderly Woman With Dyspnea

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider