Document Detail


Role of rheolytic thrombectomy in massive pulmonary embolism with contraindication to systemic thrombolytic therapy.
MedLine Citation:
PMID:  20142224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Mortality of massive pulmonary embolism remains exceedingly high despite thrombolytic therapy. Despite initial encouraging results, rheolytic thrombectomy has not been considered the first choice of treatment in the current European Guidelines for massive pulmonary embolism, even in cases of major contraindication to thrombolysis. Our objective was to assess the efficacy of rheolytic thrombectomy in the specific treatment of massive pulmonary embolism with contraindication to systemic thrombolytic therapy. METHODS AND RESULTS: Between January 2003 and April 2008 a total of 10 patients with massive pulmonary embolism referred for rheolytic thrombectomy were included. Clinical data including medical history, haemodynamic status, procedural characteristic, in-hospital complications and survival were collected. Seven patients survived after undergoing the procedure, three patients died in during their initial hospitalisation however, two of these deaths were not attributable to the pulmonary embolism or the procedure. Rheolytic thrombectomy resulted in reduction of mean pulmonary artery pressures from 34.6+/-13.1 mmHg to 26.9+/-8.2 mmHg immediately following the procedure. Additionally, the Miller index improved from 22.4+/-2.8 to 9.8+/-2.7. There were no periprocedural bleeding complications associated with the procedure. CONCLUSIONS: Rheolytic thrombectomy might be an effective and safe treatment for massive pulmonary embolism when systemic thrombolytic therapy is contraindicated. These data form the basis for further clinical investigation of this novel therapy among patients with massive pulmonary embolism.
Authors:
Dabit Arzamendi; Luc Bilodeau; Reda Ibrahim; Stephane Noble; Richard Gallo; Philippe Lavoie-L'allier; Gilbert Gosselin; Pierre Deguise; Hung Ly; Jean-François Tanguay; Serge Doucet
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  5     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  716-21     Citation Subset:  IM    
Affiliation:
Montreal Heart Institute, Montreal, Canada. arzamend@clinic.ub.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Echocardiography, Doppler
Equipment Design
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pulmonary Embolism / diagnosis,  surgery*
Retrospective Studies
Risk Factors
Severity of Illness Index
Thrombectomy / instrumentation*
Thrombolytic Therapy / contraindications*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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