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June 4, 2021Current Cardiology ReviewsOpen Access

Catheter-directed Thrombolysis versus Systemic Anticoagulation for Submassive Pulmonary Embolism: A Meta-Analysis

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Key result

Catheter-directed thrombolysis was associated with lower 30-day mortality compared to systemic anticoagulation for submassive pulmonary embolism (OR 0.27; 95% CI 0.11-0.67).

Why the study?

The optimal therapy for submassive pulmonary embolism remains in question.

Does Catheter-Directed Thrombolysis reduce mortality in patients with submassive pulmonary embolism compared to Systemic Anticoagulation?

Population

Patients with submassive pulmonary embolism across six studies

Comparison

Catheter-directed thrombolysis vs systemic anticoagulation

Design

Meta-analysis

Follow-up

Up to one-year

Discussion

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Overview

May support catheter-directed thrombolysis in submassive PE; extends observational data but requires randomized confirmation.

Key Points

  • To evaluate the efficacy and safety of catheter-directed thrombolysis compared to systemic anticoagulation in patients with submassive pulmonary embolism.
  • Searched PubMed and Google Scholar for studies comparing catheter-directed thrombolysis against systemic anticoagulation in submassive pulmonary embolism.
  • Identified and synthesized data from 6 eligible comparative studies.
  • Evaluated primary clinical endpoints of 30-day, 90-day, and 1-year mortality, alongside major bleeding complications.
  • Catheter-directed thrombolysis significantly reduced 30-day mortality (OR 0.27, 95% CI 0.11–0.67) and 1-year mortality (OR 0.50, 95% CI 0.28–0.89) compared to systemic anticoagulation.
  • Ninety-day mortality showed no statistically significant difference between arms (OR 0.57, 95% CI 0.17–1.92), though pooled mortality beyond 30 days favored catheter-directed therapy (OR 0.51, 95% CI 0.30–0.86).
  • Risk of major bleeding events was not statistically different between catheter-directed thrombolysis and systemic anticoagulation (OR 1.63, 95% CI 0.63–4.20).

Study Design

Type

Meta-Analysis

Structured PICO

Does Catheter-Directed Thrombolysis reduce mortality in patients with submassive pulmonary embolism compared to Systemic Anticoagulation?

P
Population
Meta-analysis of 6 studies comparing catheter-directed thrombolysis versus systemic anticoagulation for the treatment of submassive pulmonary embolism.
I
Intervention
Catheter-Directed Thrombolysis (CDT)
C
Comparator
Systemic Anticoagulation (SA)
O
Outcome
Mortality (30-day, 90-day, and one-year)hard clinical

Main Result

Odds Ratio: 0.27 (95% CI 0.11–0.67)

Catheter-directed thrombolysis is associated with lower 30-day and 1-year mortality compared to systemic anticoagulation in submassive pulmonary embolism, without a significant increase in major bleeding.

Cite This Study

A 2021 study conducted a meta-analysis in Submassive pulmonary embolism. Catheter-Directed Thrombolysis (CDT) vs. Systemic Anticoagulation (SA) was evaluated on 30-day mortality (OR 0.27, 95% CI 0.11-0.67). Catheter-directed thrombolysis was associated with lower 30-day mortality compared to systemic anticoagulation for submassive pulmonary embolism (OR 0.27; 95% CI 0.11-0.67).

synapsesocial.com/papers/6a8fa2dd0dca898c22cb416chttps://doi.org/10.2174/1573403x17666210603114116
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Also Consider

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

  1. 1Outcomes of catheter‐directed thrombolysis vs. standard medical therapy in patients with acute submassive pulmonary embolism2019 · 27 citations
  2. 2Systematic review and meta-analysis for thrombolysis treatment in patients with acute submassive pulmonary embolism2014 · 24 citations
  3. 3Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism2013 · 1,144 citations
  4. 4Comparative Outcomes of Ultrasound-Assisted Thrombolysis and Standard Catheter-Directed Thrombolysis in the Treatment of Acute Pulmonary Embolism2016 · 63 citations
  5. 5Ultrasound‐assisted catheter‐directed thrombolysis compared with anticoagulation alone for treatment of intermediate‐risk pulmonary embolism2018 · 27 citations