title: Pharmaco-mechanical management of acute massive pulmonary embolism in a postpartum female.
abstract: BACKGROUND
  The optimal use of pharmaco-mechanical therapy is not clear in the management of the acute massive pulmonary thromboembolism.
  
  
  METHODS
  A 30-year-old postpartum female presented with acute massive pulmonary embolism and was managed with catheter mediated thrombus aspiration and fragmentation after the standard intravenous thrombolysis had failed. Thrombus was aspirated by 7F Mullins sheath with 50 cc aspiration syringe and was fragmented by TYSHAK II PTV balloon. This was followed by catheter directed thrombolysis.
  
  
  RESULTS
  Intravenous thrombolysis was only partially successful whereas catheter mediated thrombus aspiration and fragmentation followed by catheter directed thrombolysis resulted in hemodynamic stabilization and early discharge from the hospital.
  
  
  CONCLUSIONS
  Pharmaco-mechanical therapy is an effective therapy of acute massive pulmonary embolism and may be beneficial over the standard systemic thrombolysis.
authors: Senior Resident, Department of Cardiology, Dr RML Hospital and PGIMER, Baba Kharak Singh Marg, New Delhi 110001, India. Electronic address: dr_sandeepgoel@yahoo.com.
authors: Sandeep
authors: S
authors: Goel
authors: Associate Professor, Department of Cardiology, Dr RML Hospital and PGIMER, Baba Kharak Singh Marg, New Delhi 110001, India.
authors: Ranjit
authors: R
authors: Nath
authors: Professor, Department of Cardiology, Dr RML Hospital and PGIMER, Baba Kharak Singh Marg, New Delhi 110001, India.
authors: Neeraj
authors: N
authors: Pandit
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D049590:Postpartum Period; D011655:Pulmonary Embolism / Q000628:therapy*; D013396:Suction / Q000379:methods*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents
keywords: Catheter directed thrombolysis (CDT); Pharmaco-mechanical therapy (PMT); Streptokinase (STK)