| Intravascular ultrasound in patients with acute pulmonary embolism after treatment with intravenous urokinase and high-dose heparin. | |
| | |
MedLine Citation:
|
PMID: 9038699 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To compare the diagnostic value of intravascular ultrasound (IVUS) with angiography in patients with pulmonary embolism. DESIGN: Open, prospective clinical study. SETTING: Two university hospitals. PATIENTS: Angiography and IVUS were used in 11 patients (5 men) (mean (SD) age 50 (18) years) with acute pulmonary embolism. INTERVENTIONS: At a mean (SD) of 6 (4) hours after thrombolytic therapy with urokinase and full-dose heparin, all patients underwent pulmonary artery angiography. Then 3.5 F mechanical, 20 or 30 MHz IVUS catheters were advanced into the pulmonary circulation. MAIN OUTCOME MEASURES: The pulmonary circulation was studied by both methods to detect the presence of thrombus, and a modified Miller score (assessing perfusion defects only and not velocity of flow) was used to quantify the angiographic images. RESULTS: The modified Miller score was mean (SD) 7.4 (2.3) points. 168 pulmonary artery segments (diameter range 2-14 mm) were studied by angiography and IVUS. On angiography, seven segments showed complete obstruction and 49 partial obstruction; 112 were normal. Two distinct types of thrombus formation were found by IVUS. Type A thrombus only partly adhered to the wall but otherwise was mobile and type B predominantly adhered to the wall. IVUS confirmed all seven angiographically complete obstructions but missed three (6%) of the 49 partial occlusions. Forty (87%) of the remaining 46 segments had type A thrombus and six (13%) type B. IVUS indicated a thrombus in 38 (34%) of the 112 angiographically normal segments; 20 (53%) showed a type A pattern and 18 (47%) a type B pattern (P < 0.001). CONCLUSION: IVUS was more sensitive than angiography in detecting thrombus but the clinical impact of this finding is not clear as yet. |
| | |
Authors:
|
G Görge; S Schuster; J Ge; J Meyer; R Erbel |
Related Documents
:
|
7457209 - Aneurysm of the popliteal vein as a cause of pulmonary embolism. 12368369 - How to use a gestalt interpretation for ventilation-perfusion lung scintigraphy. 11533069 - D-dimer testing: the role of the clinical laboratory in the diagnosis of pulmonary embo... 17555069 - Peripheral pulmonary embolism on multidetector ct pulmonary angiography. 7865399 - Acute lower limb ischemia complicating endocarditis due to candida parapsilosis in a dr... 2707089 - Recurrent pulmonary embolism. a prospective study. 12645719 - Cannulation of the axillary artery for cardiopulmonary bypass: safeguards and pitfalls. 18821859 - Tandem measurement of d-dimer and myeloperoxidase or c-reactive protein to effectively ... 11722039 - Better ischemic event-free survival after two internal thoracic artery grafts: 13 years... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Heart (British Cardiac Society) Volume: 77 ISSN: 1355-6037 ISO Abbreviation: Heart Publication Date: 1997 Jan |
Date Detail:
|
Created Date: 1997-03-11 Completed Date: 1997-03-11 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 9602087 Medline TA: Heart Country: ENGLAND |
Other Details:
|
Languages: eng Pagination: 73-7 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiology, University Hospital, Essen, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Adult Aged Drug Administration Schedule Female Heparin / administration & dosage*, therapeutic use Humans Hypertension, Pulmonary / drug therapy Male Middle Aged Prospective Studies Pulmonary Artery / radiography Pulmonary Embolism / drug therapy, radiography, ultrasonography* Thrombolytic Therapy* Ultrasonography, Interventional* Urokinase-Type Plasminogen Activator / therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
9005-49-6/Heparin; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Anatomical and echocardiographic correlates of normal cardiac morphology in the late first trimester...
Next Document: Intracoronary demonstration of adenosine-induced coronary collateral steal.