AI Article Synopsis
- The study compares the prognosis of local thrombolysis versus systemic thrombolysis in patients with high-risk pulmonary embolism over 13 years, involving 37 patients treated locally and 36 systemically.
- Local thrombolysis led to a complete remission of cardiogenic shock and a significantly lower in-hospital mortality rate compared to systemic thrombolysis.
- Both treatment methods had similar outcomes regarding pressure gradient reduction and long-term survival rates, but local thrombolysis showed better improvement in residual pulmonary hypertension during the 24-month follow-up.
Article Abstract
To evaluate the prognosis after local thrombolysis compared to systemic thrombolysis in high-risk pulmonary embolism. Observational study during 13 years which included 37 patients with high-risk pulmonary embolism treated with local thrombolysis and 36 patients with systemic thrombolysis (streptokinase, 250 000 UI/30 minutes followed by 100 000 UI/h). Cardiogenic shock has totally remitted in the group with local thrombolysis ( = .002). The decrease in pressure gradient between right ventricle and right atrium was comparable in both groups in the acute period (the results being influenced by the higher in-hospital mortality after systemic thrombolysis), but significantly better in the next 24 months follow-up after in situ thrombolysis. Major and minor bleeding did not have significant differences. In hospital, mortality was significantly lower in the group with local thrombolysis ( = .003), but for the next 24 months follow-up, the survival was comparable in both groups. Local thrombolysis, during the hospitalization, was associated with lower mortality rate comparing with systemic thrombolysis. In the next 24 months follow-up, the evolution of residual pulmonary hypertension was significantly better after in situ thrombolysis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444095 | PMC |
| http://dx.doi.org/10.1177/1076029620929764 | DOI Listing |
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