title: Recent advances in interventional radiology for acute massive pulmonary thromboembolism.
abstract: Acute massive pulmonary thromboembolism is life-threatening and requires vigorous treatment. Anticoagulation is the most traditional treatment for pulmonary thromboembolism, but may not be sufficient for massive thromboemboli. Systemic thrombolytic therapy and surgical thrombectomy are the traditional therapeutic options in this situation. Catheter-directed thrombolysis, percutaneous embolectomy and, more recently, percutaneous thrombus fragmentation techniques using specialized devices are now available to treat the most severe cases of massive pulmonary thromboembolism. The success of these techniques depends on a thorough understanding of the mechanism of action of each of the devices and familiarity with the relevant catheterization techniques. We present a review of currently available equipment and techniques, and describe our work with hybrid treatment using a combination of mechanical fragmentation, localized fibrinolysis and clot aspiration.
authors.affiliation: Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan. h-tajima@nms.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tajima
authors.forename: Satoru
authors.initials: S
authors.lastname: Murata
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kumazaki
authors.forename: Ken
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
mesh_terms: D000208:Acute Disease; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000628:therapy*; D015641:Radiography, Interventional / Q000639:trends*