Relation of ultrasound morphologic characteristics of central pulmonary artery thromboemboli to their ex vivo lysibility.
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.
Podbregar
Matej
M
Clinical Department for Intensive Care Medicine, Clinical Center, Ljubljana, Slovenia. matej.podbregar@guest.arnes.si
Gabrscek
Lucija
L
Pakiz
Maja
M
Blinc
Ales
A
Sabović
Miso
M
Kralj
Eduard
E
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*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator