Ultrasound-assisted thrombolysis for acute pulmonary embolism: a systematic review.
Pulmonary embolism remains a common and potentially life-threatening disease. For patients with intermediate- and high-risk pulmonary embolism, catheter-based revascularization therapy has emerged as potential alternative to systemic thrombolysis or surgical embolectomy. Ultrasound-assisted catheter-directed thrombolysis is a contemporary catheter-based technique and is the focus of the present review. Ultrasound-assisted catheter-directed thrombolysis is more effective in reversing right ventricular dysfunction and dilatation in comparison with anticoagulation alone in patients at intermediate risk. However, a direct comparison of ultrasound-assisted thrombolysis with systemic thrombolysis or surgical thrombectomy is not available. Ultrasound-assisted thrombolysis with initial intrapulmonary thrombolytic bolus may also be effective in high-risk patients, but evidence from randomized trials is not available. This review summarizes current data on ultrasound-assisted thrombolysis for acute pulmonary embolism.
Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, University Hospital, University of Bern, 3010 Bern, Switzerland.
Rolf P
RP
Engelberger
Nils
N
Kucher
D000208:Acute Disease; D002404:Catheterization / Q000379:methods; D003131:Combined Modality Therapy; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D061185:Mechanical Thrombolysis / Q000379:methods*; D011655:Pulmonary Embolism / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D018084:Ultrasonography, Interventional / Q000379:methods*
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
Bleeding; Catheter-based revascularization; Pulmonary embolism; Ultrasound-assisted thrombolysis