Safety of catheter-directed thrombolysis for massive and submassive pulmonary embolism: Results of a multicenter registry and meta-analysis.

Objectives: To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) in the treatment of acute pulmonary embolism (PE).

Background: The use of CDT for the treatment of acute submassive and massive PE is increasing in frequency. However, its safety and efficacy have not been well elucidated.

Fulminant Myocarditis with Combination Immune Checkpoint Blockade.

Immune checkpoint inhibitors have improved clinical outcomes associated with numerous cancers, but high-grade, immune-related adverse events can occur, particularly with combination immunotherapy. We report the cases of two patients with melanoma in whom fatal myocarditis developed after treatment with ipilimumab and nivolumab. In both patients, there was development of myositis with rhabdomyolysis, early progressive and refractory cardiac electrical instability, and myocarditis with a robust presence of T-cell and macrophage infiltrates.

Acute Pulmonary Embolism Network and Multidisciplinary Response Team Approach to Treatment.

Background: The ideal treatment strategy for acute pulmonary embolism (PE) remains a subject of debate. Treatment strategies vary based on numerous factors including the clinical scenario, hemodynamic variables, PE location, and personnel who are trained in advanced PE management therapies.

Methods: Similar to an acute myocardial infarction network, we created a regional referral system called the Acute PE Network to facilitate the transport of patients with PE from referring facilities and improve access to advanced therapies.

Hybrid endovascular pseudoaneurysm and pulmonary stenosis repair in bovine arch.

This case report details the endovascular management of a large aortic pseudoaneurysm in a high-risk patient with a complicated history using a multi-disciplinary, hybrid approach. The pseudoaneurysm compressed the main pulmonary artery to 5 mm with near complete obstruction of the left main pulmonary artery, while also compromising the lumens of the left superior pulmonary vein and left main bronchus. Furthermore, the patient's left upper extremity arteriovenous dialysis fistula and bovine arch anatomy required a hybrid approach of repair that preserved the fistula while treating the aortic, pulmonary, and bronchial pathology.