Key result
A combination of catheter extraction, regional thrombolysis, systemic heparin, and IVC filter placement successfully managed massive pulmonary embolism in a 3-year-old child.
Case Report (n=1)
This case demonstrates the feasibility of using catheter extraction and regional thrombolysis alongside systemic heparin and IVC filter placement for massive pulmonary embolism in a small child.
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Supports feasibility of multimodal endovascular therapy in pediatric massive PE; leaves open safety and efficacy in larger cohorts.
Massive pulmonary embolism (PE) in a small child is a rare event and unified guidelines for its treatment are missing. Timely diagnosis and management of massive pulmonary embolism is of crucial importance for a good outcome. We describe a unique management of PE causing oxygenation failure using a combination of catheter extraction technique, and regional thrombolysis on top of systemic heparin administration and inferior vena cava filter placement. Pulmonary hypertension was treated with inhaled nitric oxide. We believe that catheter extraction technique and regional thrombolysis is an option to consider provided that resources and expertise are available. Preoperative placement of an inferior vena cava filter should be contemplated in such high risk situations.
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Hudcova et al. (2009) conducted a case report in Postoperative pulmonary embolism in Klippel-Trenaunay syndrome (n=1). Catheter extraction technique, regional thrombolysis, systemic heparin, and inferior vena cava filter placement was evaluated on Management of PE causing oxygenation failure. A combination of catheter extraction, regional thrombolysis, systemic heparin, and IVC filter placement successfully managed massive pulmonary embolism in a 3-year-old child.
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