scholarly journals Massive Pulmonary Embolism Thrombolysis: Early Clinical Markers of Treatment Efficacy

2018 ◽  
Vol 02 (01) ◽  
pp. 017-022
Author(s):  
Elie Portnoy ◽  
Vibhor Wadhwa ◽  
Mariana Barbosa ◽  
Clifford Weiss ◽  
Brian Holly ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Improvement ◽  
Pulmonary Arterial Pressure ◽  
Massive Pulmonary Embolism ◽  
Hemodynamic Parameters ◽  
Clinical Markers ◽  
Treatment Protocols ◽  
Radiology Service ◽  
Catheter Directed Thrombolysis ◽  
Pulmonary Arterial

AbstractThe authors seek to evaluate hemodynamic parameters as potential clinical markers of real-time clinical improvement among patients with massive pulmonary embolism (PE) in correlation with post-thrombolytic pulmonary arterial pressure improvement and overall clinical outcome. Thirteen patients with submassive or massive PE were admitted to the interventional radiology service and treated with catheter-directed thrombolysis. Among the four patients who qualified as massive PE, systolic blood pressure (BP) and vasopressor dependence suggested meaningful trends toward clinical improvement, after only 26.4% of treatment course/dose. Hemodynamic parameters such as systolic BP and inotropic vasopressor dependence may be considered in future treatment protocols as early indicators of treatment response.

COVID-19 complicated by pulmonary embolism treated with catheter directed thrombectomy

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Francisco Leonardo Galastri ◽  
Leonardo Guedes Moreira Valle ◽  
Breno Boueri Affonso ◽  
Marcela Juliano Silva ◽  
Rodrigo Gobbo Garcia ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Dynamic Process ◽  
Therapeutic Option ◽  
Massive Pulmonary Embolism ◽  
Percutaneous Intervention ◽  
Thromboembolic Events ◽  
Emergency Center ◽  
Catheter Directed Thrombolysis

Summary: COVID-19 is a recently identified illness that is associated with thromboembolic events. We report a case of pulmonary embolism in a patient with COVID-19, treated by catheter directed thrombectomy. A 57 year old patient presented to the emergency center with severe COVID-19 symptoms and developed massive pulmonary embolism. The patient was treated with catheter directed thrombolysis (CDT) and recovered completely. Coagulopathy associated with COVID-19 is present in all severe cases and is a dynamic process. We describe a case of massive/high risk pulmonary embolism, in a patient with COVID-19 receiving full anticoagulation, who was treated by percutaneous intervention. CDT can be an additional therapeutic option in patients with COVID-19 and pulmonary embolism that present with rapid clinical collapse.

scholarly journals A pulmonary embolism response team’s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism

2017 ◽  
Vol 23 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Akhilesh K Sista ◽  
Oren A Friedman ◽  
Eda Dou ◽  
Brendan Denvir ◽  
Gulce Askin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Brain Cancer ◽  
Massive Pulmonary Embolism ◽  
Bleeding Rate ◽  
Systemic Thrombolysis ◽  
Multidisciplinary Assessment ◽  
Catheter Directed Thrombolysis ◽  
Assessment And Treatment ◽  
Institutional Experience ◽  
Hospital Deaths

Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded. A total of 124 PERT activations occurred over 20 months: 43 in the first 10 months and 81 in the next 10. A total of 87 submassive (90.8%) and massive (9.2%) PE patients were included. The median age was 65 (51–75 IQR) years. Catheter-directed thrombolysis (CDT) was administered to 25 patients, systemic thrombolysis (ST) to six, and anticoagulation alone (AC) to 54. The median ICU stay and overall LOS were 6 (3–10 IQR) and 7 (4–14 IQR) days, respectively, with no association with any variables except a brain natriuretic peptide (BNP) >100 pg/mL ( p=0.008 ICU LOS; p=0.047 overall LOS). Twelve patients (13.7%) died in the hospital, nine of whom had metastatic or brain cancer, with a median overall LOS of 13 (11–17 IQR) days. There were five major bleeds: one in the CDT group, one in the ST group, and three in the AC group. Overall, (1) PERT activations increased after the first 10 months; (2) BNP >100 pg/mL was associated with a longer LOS; (3) rates of mortality and bleeding did not correlate with treatment; and (4) the majority of in-hospital deaths occurred in patients with advanced cancer.

Successful catheter-directed thrombolysis of a massive pulmonary embolism in a patient after recent pneumonectomy

2015 ◽  
Vol 39 (1) ◽  
pp. 140-143 ◽  
Author(s):  
Kyungmouk S. Lee ◽  
Akhilesh K. Sista ◽  
Oren A. Friedman ◽  
James M. Horowitz ◽  
Jeffrey L. Port ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Massive Pulmonary Embolism ◽  
Catheter Directed Thrombolysis

Echocardiographic assessment of pulmonary arterial pressure in the follow-up of patients with pulmonary embolism

2011 ◽  
Vol 127 (4) ◽  
pp. 303-308 ◽  
Author(s):  
Remedios Otero ◽  
Mikel Oribe ◽  
Aitor Ballaz ◽  
David Jimenez ◽  
Fernando Uresandi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Echocardiographic Assessment ◽  
Pulmonary Arterial
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