Key result
Catheter-directed thrombolysis with alteplase resulted in rapid resolution of symptoms and decreased pulmonary artery pressures from 45 mmHg to 22 mmHg at 24 hours in a patient with submassive pulmonary embolism.
Case Report (n=1)
Catheter-directed thrombolysis can be successfully utilized for the treatment of submassive pulmonary embolism in resource-limited settings.
May raise suspicion for PE in young patients with occupational risks; leaves open validation in larger cohorts.
We describe a case of a young male who presented with acute onset progressively worsening shortness of breath for four days duration. He used to smoke cigarettes, and his profession required prolonged periods of standing. He underwent a two-dimensional echocardiogram showing right ventricular (RV) strain and computed tomography (CT) showing thrombus in the left major pulmonary artery. His pulmonary embolism severity index (PESI) score was high, predicting higher short-term mortality. Treatment options including risks and benefits were discussed with the patient, and he underwent catheter-directed thrombolysis (CDT) with rapid resolution of symptoms, oxygen saturation, and pulmonary artery pressures (PAP). He was discharged home safely after successful treatment of his condition.
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Gurjar et al. (2022) conducted a case report in Submassive Pulmonary Embolism (n=1). Catheter-directed thrombolysis (alteplase) was evaluated on Symptomatic and hemodynamic improvement. Catheter-directed thrombolysis with alteplase resulted in rapid resolution of symptoms and decreased pulmonary artery pressures from 45 mmHg to 22 mmHg at 24 hours in a patient with submassive pulmonary embolism.
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