Role of rheolytic thrombectomy in massive pulmonary embolism with contraindication to systemic thrombolytic therapy

2010 ◽  
Vol 5 (6) ◽  
pp. 716-721 ◽  
Author(s):  
Dabit Arzamendi ◽  
Luc Bilodeau ◽  
Reda Ibrahim ◽  
Stephane Noble ◽  
Richard Gallo ◽  
...  
2015 ◽  
Vol 3 (4) ◽  
Author(s):  
Lexin Wang

Pulmonary embolism is a common disease that is associated with significant mobility and mortality. Thrombolysis is potentially life saving when used in conjunction with anticoagulant therapy. Indications for thrombolysis for pulmonary embolism are not well defined. In patients with acute massive pulmonary embolism and hypotension, thrombolytic therapy offers some benefits in terms of mortality reduction. The use of thrombolysis in patients with stable haemodynamics has been controversial for more than two decades. Recent clinical studies have indicated that thrombolytic treatment in conjunction with heparin in patients with submassive pulmonary embolism and normal blood pressure can prevent deterioration of the disease and diminish the need for more intensive therapies during hospitalisation. The role of prehospital thrombolytic therapy for acute pulmonary embolism is unclear and further clinical studies are warranted.


2014 ◽  
Vol 34 (03) ◽  
pp. 233-236
Author(s):  
C. Martin ◽  
F. Alt ◽  
A. Wingerter ◽  
G. Staatz ◽  
H. Schinzel ◽  
...  

SummaryAcute pulmonary embolism (PE) is a serious complication in association with malignant diseases. We describe the successful treatment of PE applying a systemic thrombolytic therapy in a 4-year-old boy with acute lymphoblastic leukaemia.The thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) 0.1 mg/ kg bodyweight per hour for six hours was continued for six days without important side effects. In particular no bleeding complications were observed. Computed tomography with contrast revealed a remarkable regression of the central PE. Without further delays the chemotherapy was resumed.


Perfusion ◽  
2009 ◽  
Vol 24 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Kevin E. Griffith ◽  
Eric Jenkins ◽  
Jonathan Haft

Massive pulmonary embolism (PE) is associated, historically, with a high mortality rate.Treatment options include systemic anticoagulation, catheter-directed thrombolytic therapy, surgical embolectomy, fragmentation techniques, and catheter embolectomy. Extracorporeal membrane oxygenation (ECMO) repeatedly has demonstrated effectiveness in providing cardiopulmonary support for the patient with a massive PE too unstable to undergo thrombolysis or embolectomy. The present case study describes a morbidly obese patient, status post gastric bypass surgery, who presented with PE, and acute respiratory and cardiac failure. A description of the patient’s management plan, which includes a simple, rapidly deployed ECMO system (Levitronix® CentriMag® and Jostra Quadrox D), systemic- and catheter-directed thrombolytic therapy and rheolytic thrombectomy (AngioJet® Series 3000, Possis Medical, Minneapolis, MN).


2016 ◽  
Vol 31 (10) ◽  
pp. 676-679 ◽  
Author(s):  
Aaron Samuel Weinberg ◽  
Suhail Dohad ◽  
Danny Ramzy ◽  
Hooman Madyoon ◽  
Victor F. Tapson

Clinical guidelines support the use of systemic thrombolytic therapy for acute massive pulmonary embolism (PE). When anticoagulation and thrombolysis fail or are contraindicated, options become limited. We report an acute PE case in which treatment options were limited, and a novel device, the FlowTriever (Inari Medical, Irvine, California), was successfully used. This is the first case report of the use of this device that we are aware of.


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