scholarly journals Complex space of Retzius lymphocele resulting in iliac compression and submassive pulmonary embolism after robotic Retzius sparing prostatectomy

2021 ◽  
Vol 36 ◽  
pp. 101598 ◽  
Author(s):  
Charlotte C. Goldman ◽  
Christopher P. Dall ◽  
Tamir Sholklapper ◽  
Jacob Brems ◽  
Keith Kowalczyk
Keyword(s):  
Pulmonary Embolism ◽  
Complex Space ◽  
Submassive Pulmonary Embolism

Advanced Management Options for Massive and Submassive Pulmonary Embolism

2016 ◽  
Vol 10 (1) ◽  
pp. 30 ◽  
Author(s):  
Sonika Malik ◽  
◽  
Anju Bhardwaj ◽  
Matthew Eisen ◽  
Sanjay Gandhi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Right Ventricular Dysfunction ◽  
Hemodynamic Instability ◽  
Adverse Outcomes ◽  
Intermediate Risk ◽  
Management Options ◽  
Vena Cava Filters ◽  
Submassive Pulmonary Embolism ◽  
Risk Patients

Pulmonary embolism (PE) is an important cause of morbidity and mortality and presents with significant diagnostic and therapeutic challenges. Clinical presentation ranges from mild, nonspecific symptoms to syncope, shock, and sudden death. Patients with hemodynamic instability and/ or signs of right ventricular dysfunction are at high risk for adverse outcomes and may benefit from aggressive therapy and support. Therapeutic anticoagulation is indicated in all patients in the absence of contraindications. Thrombolysis should be strongly considered in selected high- and intermediate-risk patients, either by systemic infusion or percutaneous catheter-directed therapy. Other therapeutic modalities, such as vena cava filters and surgical embolectomy, are options for patients who fail or cannot tolerate anticoagulation and/or thrombolysis. This article reviews the assessment and advanced management options for acute PE with focus on high- and intermediate-risk patients.

scholarly journals Clinical outcomes of submassive pulmonary embolism thrombolysis—an Indian experience

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Nadeem U. Rehman ◽  
Mohd Iqbal Dar ◽  
Manish Bansal ◽  
R. R. Kasliwal
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Systolic Dysfunction ◽  
Massive Pulmonary Embolism ◽  
Post Treatment ◽  
Control Group ◽  
Submassive Pulmonary Embolism ◽  
Venous Thromboembolic ◽  
Pre Treatment ◽  
And Control

Abstract Background Acute pulmonary thromboembolism is the most dangerous presentation of venous thromboembolic disease. The role of thrombolysis in massive pulmonary embolism has been studied extensively, but the same is not there for submassive pulmonary embolism. This study is aimed at evaluating the effects of thrombolysis in acute submassive pulmonary embolism. This was a prospective, case-control, observational study. Patients presenting with acute submassive pulmonary embolism were divided into thrombolysis group and control group depending on whether they received thrombolysis plus anticoagulation or anticoagulation only, respectively. Results A total of 86 patients were included in the study. Forty-two patients were in the thrombolysis group, and 44 patients were in the control group. The mean ± SD age in the control and thrombolysis groups was 63.3 ± 14.7 and 56.4 ± 13.8 years, respectively. The two groups were well matched in sex distribution and associated comorbidities like COPD, active surgery, major trauma, and immobilization. On echocardiography, dilated RA/RV in pre-treatment vs. post-treatment was seen in 20 (45.5%) vs. 20 (45.5%) in the control group and 26 (61.9%) vs. 11 (26.2%) in the thrombolysis group. Similarly, RV systolic dysfunction in pre-treatment vs. post-treatment was seen in 24 (54.5%) vs. 21 (47.7%) in the control group and 22 (52.4%) vs. 8 (19.0%) in the thrombolysis group. Pulmonary artery pressure in pre-treatment vs. post-treatment was 64.4 ± 15.0 vs. 45.9 ± 9.9 mmHg in the control group and 68.3 ± 17.4 vs. 31.4 ± 6.9 mmHg in the thrombolysis group. In control vs. thrombolysis group, there were 5 vs. 1 death, 6 vs. 1 hemodynamic decompensation, and 6 vs. 1 patient needing mechanical ventilation. Conclusion Thrombolysis in submassive pulmonary embolism is associated with better right ventricular functions, lower pulmonary artery pressures, and comparable mortality rates.

A Massive Pulmonary Embolism Treatment Protocol: How Trauma Performance Improvement Affects Outcome Throughout the Hospital System

2010 ◽  
Vol 76 (2) ◽  
pp. 145-148
Author(s):  
Catherine Garrison Velopulos ◽  
Mark Zumberg ◽  
Priscilla Mcauliffe ◽  
Lawrence Lottenberg ◽  
A. Joseph Layon
Keyword(s):  
Pulmonary Embolism ◽  
Sudden Death ◽  
Performance Improvement ◽  
Pulmonary Embolus ◽  
Treatment Protocol ◽  
Right Heart Failure ◽  
Hospital Performance ◽  
Massive Pulmonary Embolism ◽  
Hospital System ◽  
Submassive Pulmonary Embolism

Trauma performance improvement is the hallmark of a mature trauma center. If loop closure is to be complete, preventable deaths must result in significant change in management and the establishment of protocol-driven improvements so such an instance does not recur. The trauma performance improvement committee reviewed a case of a massive pulmonary embolus and determined that this was a preventable death. The hospital performance improvement committee then initiated a root cause analysis, which led to creation of a treatment protocol for patients with massive or submassive pulmonary embolism. A focused review of the first 6 months of the implementation of the protocol was undertaken. Four patients over a 6-month period had massive or submassive pulmonary embolus. All four had sudden death or near sudden death and were appropriately resuscitated. All four sustained right heart failure. Two patients were treated by catheter-directed fibrinolysis, one with catheter-directed suction embolectomy, and one by surgical pulmonary embolectomy. All survived with full neurologic function. Trauma performance improvement is the model by which all hospital performance improvement should be done. Preventable deaths can result in change, which can have a future impact on survival in potentially lethal scenarios.

Randomized Trial Comparing Standard Versus Ultrasound-Assisted Thrombolysis for Submassive Pulmonary Embolism

2021 ◽  
Vol 14 (12) ◽  
pp. 1364-1373 ◽  
Author(s):  
Efthymios D. Avgerinos ◽  
Wissam Jaber ◽  
Joan Lacomis ◽  
Kyle Markel ◽  
Michael McDaniel ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Randomized Trial ◽  
Submassive Pulmonary Embolism ◽  
Ultrasound Assisted

Comparison Of Outcomes In Catheter-Directed Versus Ultrasound-Assisted Thrombolysis For Management Of Submassive Pulmonary Embolism

2021 ◽  
Author(s):  
Sorcha Allen ◽  
Lucas Chan ◽  
Dalila Masic ◽  
Katerina Porcaro ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Submassive Pulmonary Embolism ◽  
Ultrasound Assisted

Efficacy and Safety of Low-Dose Systemic Fibrinolytic Therapy for Acute Submassive Pulmonary Embolism

2021 ◽  
Vol 14 (7) ◽  
pp. 809
Author(s):  
Ahmet Güner ◽  
Ezgi Gültekin Güner ◽  
Seda Karakurt ◽  
Macit Kalçık
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Fibrinolytic Therapy ◽  
Efficacy And Safety ◽  
Submassive Pulmonary Embolism

Clinical factors associated with adverse outcomes in the acute period of management of submassive pulmonary embolism

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hong T. Nguyen ◽  
Patrick Leffers ◽  
Carmen Smotherman ◽  
Jason A. Ferreira
Keyword(s):  
Pulmonary Embolism ◽  
Adverse Outcomes ◽  
Clinical Factors ◽  
Acute Period ◽  
Factors Associated ◽  
Submassive Pulmonary Embolism
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