Document Detail


Catheter-directed thrombolysis with the Endowave system in the treatment of acute massive pulmonary embolism: a retrospective multicenter case series.
MedLine Citation:
PMID:  18295696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the efficacy of thrombolysis with the EndoWave peripheral infusion system in the treatment of patients with massive pulmonary embolism (PE) as compared to patients treated with catheter-directed thrombolysis. MATERIALS AND METHODS: Ten patients (five men and five women; age range, 31-85 years; mean age, 54.20 years) with massive acute PE (17 lesions) were treated with ultrasonography (US)-assisted catheter-directed thrombolysis with the Endowave system. All patients had hypoxia and dyspnea. No patient had contraindication for thrombolysis. Angiographic findings, duration of lysis, dose of thrombolytics used, and procedural complications were recorded. Thrombolytics used were urokinase, tissue-type plasminogen activator (tPA), and Reteplase. RESULTS: Complete thrombus removal was achieved in 13 of the 17 lesions (76%), near complete thrombolysis was achieved in three lesions (18%), and partial thrombolysis was achieved in one lesion (6%). The mean time of thrombolysis was 24.76 hours +/- 8.44 (median, 24 hours). The mean dose of tPA used for the Endowave group was 0.88 mg/h +/- 0.19 (13 lesions). CONCLUSIONS: US-assisted catheter-directed thrombolysis is an effective method for treating massive thrombolysis. It has the potential to shorten the time of lysis and lower the dose of thrombolytics.
Authors:
Abbas Chamsuddin; Lama Nazzal; Brandon Kang; Irwin Best; Gail Peters; Sepehr Panah; Louis Martin; Curtis Lewis; Chadi Zeinati; John W Ho; Anthony C Venbrux
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-07-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-6     Citation Subset:  IM    
Affiliation:
Department of Vascular and Interventional Radiology, Emory University Hospital, Atlanta, GA 30345, USA. abbas_chamsuddin@emoryhealthcare.org
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Catheterization
Female
Fibrinolytic Agents / administration & dosage
Humans
Male
Middle Aged
Pulmonary Embolism / drug therapy*,  ultrasonography
Recombinant Proteins / administration & dosage
Retrospective Studies
Thrombolytic Therapy / instrumentation,  methods*
Tissue Plasminogen Activator / administration & dosage
Urokinase-Type Plasminogen Activator / administration & dosage
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Recombinant Proteins; 133652-38-7/reteplase; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

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