title: Relation of ultrasound morphologic characteristics of central pulmonary artery thromboemboli to their ex vivo lysibility.
abstract: BACKGROUND
  Ultrasound morphology of massive central pulmonary artery thromboemboli (TE) is an independent predictor of 30-day mortality. The aim of this study was to asses ex vivo lysibility of morphologically different TE.
  
  
  METHODS
  Forty-five central pulmonary artery TE, collected at autopsies, were divided into hypoechoic (group A) and hyperechoic (group B) categories. TE were lysed with alteplase in a perfusing system simulating pulmonary circulation for 1 hour.
  
  
  RESULTS
  The grey scale mean of thrombi in group B was higher compared with group A (64 +/- 7 vs. 38 +/- 7, respectively, P < .01). Spontaneous lysis in group A did not differ compared with group B (2.2% +/- 0.5% vs. 2.1% +/- 0.4%, P = .4). After incubation with alteplase, the weight of TE was reduced more in group A than in group B (16% +/- 2% vs. 11% +/- 2%, P < .001). The grey scale mean negatively correlated with the percentage of TE weight reduction (0.768) (P < .001).
  
  
  CONCLUSIONS
  Ultrasound morphology of TE from central pulmonary arteries correlates significantly with ex vivo lysibility. Hypoechoic TE are more susceptible to thrombolysis than hyperechoic TE.
authors.affiliation: Clinical Department for Intensive Care Medicine, Clinical Center, Ljubljana, Slovenia. matej.podbregar@guest.arnes.si
authors.forename: Matej
authors.initials: M
authors.lastname: Podbregar
authors.forename: Lucija
authors.initials: L
authors.lastname: Gabrscek
authors.forename: Maja
authors.initials: M
authors.lastname: Pakiz
authors.forename: Ales
authors.initials: A
authors.lastname: Blinc
authors.forename: Miso
authors.initials: M
authors.lastname: Sabović
authors.forename: Eduard
authors.initials: E
authors.lastname: Kralj
mesh_terms: D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D066298:In Vitro Techniques; D008297:Male; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000187:drug effects*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator