Ultrasound-Assisted Catheter-Directed Thrombolysis: A Novel and Promising Endovascular Therapeutic Modality for Intermediate-Risk Pulmonary Embolism. (July 2017)

• Record Type: Journal Article
• Authors: Teleb, Mohamed; Porres-Aguilar, Mateo; Rivera-Lebron, Belinda; Ngamdu, Kyari Sumayin; Botrus, Gehan; Anaya-Ayala, Javier E.; Mukherjee, Debabrata
• Is Part Of: Angiology. Volume 68:Number 6(2017)
• Page Start: 494
• Page End: 501
• Publication Date: 2017-07
• Subjects: submassive pulmonary embolism -- thrombolytics -- ultrasound-assisted catheter-directed thrombolysis -- intermediate-risk pulmonary embolism; Blood-vessels -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.13005
• DOI: 10.1177/0003319716665718
• Languages: English
• ISSNs: 0003-3197

Abstract

Intermediate-risk pulmonary embolism (PE), also known as submassive PE, occurs in a substantial group of patients and carries a significant mortality risk. With adequate risk stratification, catheter-directed techniques could be used as a therapeutic approach in the intermediate-risk PE. Ultrasound-assisted catheter-directed thrombolysis (UCDT) represents a novel endovascular technique with good clinical and safety outcomes. Ultrasound-assisted catheter-directed thrombolysis can achieve reduction in the thrombus burden and improvement of pulmonary hemodynamics and right ventricular (RV) dysfunction and/or dilatation, without major procedure-related complications, major bleeding, or hemorrhagic strokes. This narrative review will focus on the major studies involving the efficacy and safety of UCDT in the intermediate-risk PE population. Prospective, randomized clinical trials with long-term follow-up and a large sample size are needed for further evaluation of mortality benefit and to further define which subgroup of patients may benefit from this novel endovascular technique.