scholarly journals Percutaneous Thrombectomy for the Treatment of Acute Massive Pulmonary Embolism: Two Case Reports

2020 ◽  
Author(s):  
Kinley Sangay Dorji ◽  
Sorracha Rookkapan ◽  
Wiwatana Tanomkiat ◽  
Keerati Hongsakul
Keyword(s):  
Pulmonary Embolism ◽  
Case Reports ◽  
Hemodynamic Instability ◽  
Massive Pulmonary Embolism ◽  
High Efficacy ◽  
Endovascular Technique ◽  
Systemic Thrombolysis ◽  
The Third ◽  
Surgical Thrombectomy ◽  
Percutaneous Thrombectomy

Pulmonary embolism (PE) is the third commonest cause of death in hospitalized patients after myocardial infarction and stroke. Surgical thrombectomy is a standard option in cases of a clinical massive PE with hemodynamic instability and in patients in whom systemic thrombolysis is contra-indicated. Percutaneous thrombectomy is a new minimally invasive alternative treatment for clinical massive PE, and it has a high efficacy, with fewer complications. We report two patients with acute massive PE that were treated successfully using the endovascular technique with suction thrombectomy.

scholarly journals Massive pulmonary embolism presenting initially as acute psychosis

2019 ◽  
Vol 12 (4) ◽  
pp. e222018
Author(s):  
Michael Lawrenz Ferreras Co ◽  
Arianne Clare Agdamag ◽  
Marcus Juan Esteban ◽  
Roselyn Mateo
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Life Support ◽  
Massive Pulmonary Embolism ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Systemic Thrombolysis ◽  
The Third ◽  
Ventricular Response ◽  
New Onset

This is a case of a 68-year-old man with Parkinson’s disease who was admitted in the psychiatry floor for new-onset aggressive behaviour and hallucinations. On the third day of hospitalisation, he suddenly developed dyspnoea followed by an ECG showing atrial fibrillation with rapid ventricular response. A few seconds later, he went into cardiac arrest; he was resuscitated after multiple rounds of Advanced Cardiovascular Life Support. A transthoracic echo showed hypokinetic and enlarged right ventricle. A CT Chest showed a saddle embolus. Patient was provided with systemic thrombolysis, which led to an improvement in his haemodynamic status. Interestingly, his psychotic symptoms also improved. In this paper, we present and review how pulmonary embolism can be associated with acute psychosis.

Systemic thrombolysis for acute massive pulmonary embolism in the immediate postoperative period after bariatric surgery

2009 ◽  
Vol 5 (2) ◽  
pp. 271-274 ◽  
Author(s):  
Rudolf A. Weiner ◽  
Markos Daskalakis ◽  
Sophia Theodoridou ◽  
Sven Fassbender ◽  
Karin Parutsch
Keyword(s):  
Bariatric Surgery ◽  
Pulmonary Embolism ◽  
Postoperative Period ◽  
Massive Pulmonary Embolism ◽  
Systemic Thrombolysis

scholarly journals CATHETER-BASED TREATMENT VERSUS SYSTEMIC THROMBOLYSIS IN ACUTE MASSIVE PULMONARY EMBOLISM: A COMPREHENSIVE META-ANALYSES

2016 ◽  
Vol 67 (13) ◽  
pp. 2064 ◽  
Author(s):  
Navkaranbir S. Bajaj ◽  
Rajat Kalra ◽  
Pankaj Arora ◽  
Sameer Ather ◽  
Jason Guichard ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Massive Pulmonary Embolism ◽  
Systemic Thrombolysis ◽  
Meta Analyses

Could advanced drug delivery systems be the future in cardiovascular revascularization medicine?

Vascular ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 447-448 ◽  
Author(s):  
Marco Zuin ◽  
Gianluca Rigatelli ◽  
Giuseppe Faggian ◽  
Roberto L’Erario ◽  
Mauro Chinaglia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Clinical Practice ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Massive Pulmonary Embolism ◽  
Bleeding Events ◽  
Systemic Thrombolysis ◽  
Future Clinical Practice ◽  
Transluminal Coronary Angioplasty

Acute myocardial infarction, stroke and pulmonary embolism required a prompt revascularization to restore the normal blood flow as soon as possible. Fibrinolytic treatment has gradually become both dated and underused in the treatment of acute myocardial infarction, after the wide diffusion of cathlab and percutaneous transluminal coronary angioplasty. Conversely, the use of systemic thrombolysis remained a benchmark in the treatment of both ischemic stroke and massive pulmonary embolism. In daily clinical practice, the use of thrombolytic agents is often limited by absolute and/or relative contraindications and possible adverse events after the drug administration, as intracranial and/or extracranial bleeding events. To minimize these problems, during the last years, the introduction of nanotechnology in the field of cardiovascular revascularization medicine has created several fascinating results. In the present article, we describe these recent findings and their possible implications in future clinical practice.

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.

scholarly journals Systemic Thrombolysis for Treatment of Postpartum Saddle Embolism Complicated by Postpartum Hemorrhage: A Case Report and Brief Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kathy Mostajeran ◽  
Hillary Boswell ◽  
Ziad Haidar
Keyword(s):  
Pulmonary Embolism ◽  
Case Report ◽  
Postpartum Hemorrhage ◽  
Postpartum Period ◽  
Case Series ◽  
Massive Pulmonary Embolism ◽  
Thromboembolic Events ◽  
Systemic Thrombolysis ◽  
Venous Thromboembolic Events ◽  
In Pregnancy

Venous thromboembolic events (VTE), specifically pulmonary embolisms, account for a significant portion of maternal morbidity and mortality. Due to the procoagulant physiological changes that occur, pregnancy and the postpartum period are known risk factors for thromboembolic events. The risk is greatest during the first-week postpartum and remains elevated for up to six weeks as compared to the general population. Treatment guidelines regarding the use of thrombolytics for massive pulmonary embolism occurring in pregnancy and the postpartum are not well established. In nonpregnant populations, thrombolytic agents are well known to decrease the mortality in the setting of a massive pulmonary embolism. However, in the absence of management guidelines, thrombolysis in pregnancy remains guided by case reports and case series. We present a case of a massive pulmonary embolism (PE) causing hemodynamic instability during the postpartum period treated with tissue plasminogen activator (tPA). The case was complicated by delayed postpartum hemorrhage successfully managed with the uterotonic methylergometrine. The patient was started on oral anticoagulation and continued for six months without recurrent VTE. Our case demonstrates a rare occurrence of a saddle embolism after a vaginal delivery within the first postpartum week which was successfully managed with the use of systemic thrombolysis and minimal intervention to manage the iatrogenic delayed postpartum hemorrhage. To the authors’ knowledge, no other similar case report exists. This case highlights the need to develop guidelines for the use of thrombolysis in mothers who present with massive pulmonary embolus and a noninvasive means to manage adverse bleeding events in the puerperium.

scholarly journals Acute Massive Pulmonary Embolism with Direct Visualization of a Free-floating Right Heart Thrombus Successfully Treated with Fibrinolysis: A Case Report

2020 ◽  
Vol 121 (1) ◽  
pp. 42-48
Author(s):  
Elisavet Kaitalidou ◽  
Dimitrios Karapiperis ◽  
Vasileios Makrakis ◽  
Maria Kipourou ◽  
Dimitrios Petroglou
Keyword(s):  
Pulmonary Embolism ◽  
Hemodynamic Instability ◽  
Massive Pulmonary Embolism ◽  
Right Atrial ◽  
Direct Visualization ◽  
Atrial Thrombus ◽  
Right Heart ◽  
Motor Weakness ◽  
History Of ◽  
The Right

A male patient with a history of immobilization due to motor weakness, was transferred to our emergency department after syncope during physiotherapy, with recorded hypotension. Transthoracic echocardiography showed severe dilatation of the right ventricle (RV), with apex hypercontractility and almost akinetic RV free wall. The above findings, in addition to the unexpected visualization of a large, free-floating, right atrial thrombus, a rare finding associated with high mortality, readily confirmed the clinical suspicion of acute pulmonary embolism (PE) causing circulatory collapse. Intravenous fibrinolysis and vasopressor therapy were successfully administered, and hemodynamic instability was soon alleviated.

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