Venous thromboembolic disease (VTE) is a health problem; around 10 million cases occur yearly with substantial morbidity and mortality. Those who survive may be left with long-term sequelae. Those sequelae might include chronic thromboembolic pulmonary hypertension, persistent right ventricular dysfunction, exercise intolerance, and reduced quality of life. Current PE management consists of anticoagulation alone, systemic thrombolysis, catheter-directed thrombolysis, and surgical embolectomy. The severity of patients with pulmonary embolism (PE) depends on the clinic and not exclusively on the extent of radiological or anatomical involvement. In this review, we present the main clinical and functional characteristics of patients in whom thrombotic fragmentation plus catheter-guided thrombolysis is used to manage acute PE of intermediate-high risk and torpid evolution within the first hours of admission.
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http://dx.doi.org/10.1016/j.cpcardiol.2022.101197 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Division of Cardiovascular Medicine, New York University, New York, New York, USA.
Background: The recently published PEERLESS trial compared catheter-directed thrombolysis (CDT) and catheter-based thrombectomy (CBT) in acute pulmonary embolism (PE). However, it included a low proportion of patients with contraindications to thrombolytic therapy (4.4%), leaving uncertainty about how CDT would perform relative to CBT in a real-world cohort with higher bleeding risk.
View Article and Find Full Text PDFCureus
November 2024
Interventional Radiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, GBR.
Pulmonary embolism (PE) is the third most frequent cause of acute cardiovascular presentation after myocardial infarction and stroke. The treatment approach for PE consists of hemodynamic and respiratory support, anticoagulation, reperfusion treatment, and vena cava filters. Reperfusion treatment consists of systemic thrombolysis (recombinant tissue-type plasminogen activator, streptokinase, and urokinase); percutaneous catheter-directed therapy (CDT); and surgical embolectomy.
View Article and Find Full Text PDFVascular
December 2024
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Background: Endovascular intervention by means of thrombolysis is emerging as a promising management of Acute Aortic Occlusion (AAO). This study aims to evaluate the outcomes of endovascular thrombectomy for AAO cases in a single-center tertiary hospital in Indonesia.
Methods: We review retrospectively AAO patients treated by Rheolytic thrombectomy ± stenting or TEVAR at our referral center from 2011 to 2024.
J Thorac Dis
November 2024
Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol
November 2024
Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Background: Early mortality rate in patients with high-risk pulmonary embolism(PE) is extremely high. Prompt and effective reduction of the thrombus load, and restoration of pulmonary circulation may successfully treat such patients. For patients with hemodynamic instability and high-risk acute PE, the guidelines recommend catheter directed therapy (CDT).
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