title: A case of acute massive pulmonary thromboembolism treated by mechanical clot fragmentation using a percutaneous transluminal angioplasty balloon.
abstract: Large, bilateral central pulmonary thromboemboli (PTE) led to cor pulmonale and severe hypoxemia in a patient who had undergone Hardy's operation. After several unsuccessful efforts (thrombolysis using a percutaneous catheter and aspiration of the emboli), mechanical clot fragmentation using a percutaneous transluminal angioplasty (PTA) balloon was attempted. This procedure was successful, resulting in a decrease in pulmonary artery pressure from 58/22 (mean 34) mmHg to 20/10 (mean 13) mmHg together with an increase in aortic pressure from 64/36 (mean 45) mmHg to 112/60 (mean 77) mmHg. Thus, mechanical clot fragmentation using a PTA balloon is a promising method for reducing pulmonary artery pressure and increasing aortic pressure in patients with acute PTE.
authors.affiliation: First Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Isoda
authors.forename: K
authors.initials: K
authors.lastname: Satomura
authors.forename: A
authors.initials: A
authors.lastname: Hamabe
authors.forename: K
authors.initials: K
authors.lastname: Hagisawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kamezawa
authors.forename: Y
authors.initials: Y
authors.lastname: Sugiyabu
authors.forename: A
authors.initials: A
authors.lastname: Kurita
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D005260:Female; D006801:Humans; D011651:Pulmonary Artery / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000628:therapy*; D015912:Thrombolytic Therapy; D016306:Vena Cava Filters