Endovascular rotary fragmentation in the treatment of massive pulmonary thromboembolism.
Endovascular rotary fragmentation using a modified pigtail catheter was provided to 20 patients with massive pulmonary thromboembolism. Fragmentation wes supplemented by the course of standard thrombolytic therapy (13 patients) or by the shortened treatment course (3 patients). Just after intervention the Miller index dropped on the average from 28.2+/-2,56 marks to 25.5+/-2.1 marks. Systolic pressure in the pulmonary artery increased on the average from 50.9+/-13.08 up to 51.9+/-13.06 mm Hg, One female patient died 1.5 h after intervention because of cardiopulmonary insufficiency progression, 3-11 days after intervention (mean 6.3 days) the patients underwent repeated cardiopulmonography. Within this period the Miller index constituted 16.7+/-4.3 marks on the average, systolic pressure in the pulmonary artery was equal to 33.8+/-9.45 mm Hg. Endovascular rotary fragmentation allows to reach swift recanalization of embolic occlusion and thus to gain a "gold hour" for thrombolysis. It improves the results of thrombolytic therapy and can become an original modality for the treatment of patients contraindicated thrombolysis.
Prokubovskĭ
V I
VI
Therapeutic Faculty, Russian State Medical University, Moscow, Russia.
Kapranov
S A
SA
Bobrov
B Iu
BIu
D000328:Adult; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000601:surgery*