Retrospective evaluation of the results of ultrasound-accelerated catheter-directed tombolysis in acute-subacute pulmonary embolism patients

Abstract

Objectives

Acute pulmonary embolism (PE) is one of the most serious forms of venous thromboembolism (VTE) with high mortality and morbidity. PE may present with right ventricular dysfunction and hemodynamic disturbances. Early diagnosis and appropriate treatment approaches play a critical role in improving survival. In this study, we evaluated the efficacy and safety of catheter-mediated thrombolytic therapy in intermediate-high-risk PE patients.

Methods

Our retrospective study was conducted at Ankara University between 2015 and 2020 and 66 intermediate-high-risk PE patients were analyzed. Clinical, biochemical and echocardiographic data of the patients were analyzed and their response to treatment was evaluated. The primary endpoint was 30-day mortality and secondary endpoints were hemodynamic improvement, length of hospitalization and complication rates.

Results

The mean age of the patients was 65 years and all of them presented with a diagnosis of symptomatic PE. After treatment, significant improvement was observed in right ventricular function, RV/LV ratio, ProBNP and Troponin I levels decreased significantly. Pulmonary artery pressures decreased and hemodynamic parameters improved. The early mortality rate after the procedure was 3% and the rate of major bleeding was low.

Conclusions

Catheter-mediated thrombolytic therapy provides hemodynamic improvement in intermediate-high-risk PE patients, while offering a low bleeding risk. Our results suggest that this therapy may be a safe and effective alternative. However, long-term results should be evaluated in large-scale, randomized studies.