| Role of rheolytic thrombectomy in massive pulmonary embolism with contraindication to systemic thrombolytic therapy. | |
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MedLine Citation:
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PMID: 20142224 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article |
Journal Detail:
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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:
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Created Date: 2010-02-09 Completed Date: 2010-09-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101251040 Medline TA: EuroIntervention Country: France |
Other Details:
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Languages: eng Pagination: 716-21 Citation Subset: IM |
Affiliation:
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Montreal Heart Institute, Montreal, Canada. arzamend@clinic.ub.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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