| ORIGINAL ARTICLE |
|
| Year : 2018 | Volume
: 4
| Issue : 2 | Page : 81-87 |
|
|
Catheter-based management of pulmonary embolism
Bishav Mohan1, Shibba Takkar Chhabra1, Amit Verma1, Hasrat Sidhu2, Abhishek Goyal1, Bhupinder Singh1, Naved Aslam1, Gurpreet Singh Wander1
1 Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
2 Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Correspondence Address:
Dr. Bishav Mohan
Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jpcs.jpcs_36_18
|
|
|
Background: Pulmonary embolism (PE) is a major cause of mortality and morbidity. Forty-four percent of patients would not have gotten intravenous (IV) thrombolysis due to contraindications or delay. Catheter-directed thrombolysis with fragmentation has been shown to improve short-term and long-term outcomes in acute high-risk patients of pulmonary embolism. Methodology: Patients presented de nova with massive pulmonary embolism or with subacute pulmonary embolism. Some presented with failed thrombolysis from other centers. Results: Our experience from these patients shows that a policy of mechanical thrombus breakdown with a 5F multipurpose or pigtail catheter followed by a urokinase infusion can achieve satisfactory results. Fifty patients with acute were treated with thrombolysis with or without mechanical breakdown. There was 96% event-free survival. With subacute PE, using a mechanical breakdown plus IV thrombolysis, there was fall in pulmonary arterial pressures (PAPs) with 100% 6-month event-free survival. In seven patients with failed thrombolysis, this strategy leads to fall in PAPs and 100% survival at 2 years. Conclusions: Various catheter-based techniques are available which can be used in combination with thrombolysis to achieve good results. Surgery should be considered if the catheter-based techniques fail. |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
