[Balloon dilatation and local thrombolysis in massive pulmonary embolism--initial results of a new therapy concept].
The high mortality rate among patients suffering from massive pulmonary embolism makes it imperative to act quickly. The first and foremost goal must be to lower the pulmonary pressure rapidly and to relieve the right ventricle. In three patients with massive pulmonary embolism we therefore tried to crush the thrombus by means of a balloon catheter. The diameters of the balloons were adapted to the size of the vessels to be treated; the balloon diameters were between 10 and 20 mm. Recanalisation resulted in a rapid improvement of perfusion and haemodynamic relief of the right ventricle. This was clinically documented by the drop in pulmonary pressure levels and an impressive improvement of general well-being. Dilation was followed by thrombolytic therapy adapted to the relevant situation. This method of thrombus crushing by means of balloon catheters is indicated in case if massive thrombi in the main stem of the a. pulmonalis, with elevated pulmonary pressure levels, and corresponding clinical signs and symptoms. It can follow alternatively as a first possibility of pressure relief directly after diagnostic pulmangiography. The initial clinical results of this new treatment method are most encouraging. Complications have not been observed so far.
Basche
S
S
Bereich kardiovaskuläre Röntgendiagnostik, Medizinisches Akademie Erfurt.
Oltmanns
G
G
D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000628:therapy*; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Ballondilatation und lokale Thrombolyse bei massiver Lungenembolie--erste Ergebnisse eines neuen Therapiekonzeptes.