Document Detail

Combined thrombolysis and inferior vena caval interruption as a therapeutic approach to massive and submassive pulmonary embolism.
MedLine Citation:
PMID:  16869467     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Massive and a submassive pulmonary embolism (PE) is a life-threatening emergency. This condition is usually treated urgently with measures to attain hemodynamic stability and anticoagulation. In selected subjects, thrombolysis, inferior vena caval interruption and embolectomy have been used. We report a consecutive case series of subjects with massive and submassive pulmonary embolism treated with both inferior vena caval interruption and thrombolysis. METHODS: Chart review of consecutive cases of massive and submassive pulmonary embolism treated with both inferior vena cava filter placement and thrombolysis. Hospital course was reviewed and subjects were followed up six months after the acute event. Complications as a result of therapy were documented. RESULTS: Sixteen subjects were identified. Ten (62.5%) subjects were categorized as submassive and six subjects (37.5%) were categorized as massive. There was no attributable mortality to PE or its treatment. Minor bleeding was seen in the majority of subjects (75 %) but major bleeding was seen in only one (6.25%) subject. Other complications were not encountered. No recurrent thromboembolic events were clinically evident during a six-month follow-up period. CONCLUSIONS: The combination of inferior vena caval interruption and thrombolysis seems safe and effective for the treatment of PE. This modality was not associated with mortality in any of our patients. The only complication encountered was bleeding primarily at the sites of vascular access. We conclude that combined vena caval interruption and thrombolysis is a safe means of treating potentially life-threatening pulmonary embolism.
Tapas Bandyopadhyay; Ismael Martin; Bimalin Lahiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Connecticut medicine     Volume:  70     ISSN:  0010-6178     ISO Abbreviation:  Conn Med     Publication Date:    2006 Jun-Jul
Date Detail:
Created Date:  2006-07-27     Completed Date:  2006-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372745     Medline TA:  Conn Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-70     Citation Subset:  IM    
University of Connecticut School of Medicine, Farmington 06032, USA.
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MeSH Terms
Hospitals, General
Medical Audit
Middle Aged
Pulmonary Embolism / classification,  complications,  physiopathology,  therapy*
Thrombolytic Therapy*
Vena Cava, Inferior / surgery*

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