title: Ultrasound-assisted lysis using recombinant tissue plasminogen activator and the EKOS EkoSonic endovascular system for treating right atrial thrombus and massive pulmonary embolism: A case study.
abstract: OBJECTIVE
  Right atrial thrombus in the setting of a large pulmonary embolus is rare and is associated with serious adverse events. This case report presents the role played by EKOS EkoSonic ultrasound system in successfully treating right atrial thrombus and massive pulmonary embolism.
  
  
  METHODS
  A 69-year-old female presented with a massive pulmonary embolus and a large mobile right atrial thrombus. She was treated with catheter-directed lysis using the EKOS EkoSonic ultrasound system and tissue plasminogen activator, with complete resolution of her right atrial thrombus and a marked improvement in her pulmonary embolus and hemodynamics.
  
  
  CONCLUSIONS
  This case report provides a new and an effective option to treat right atrial thrombus associated with a large pulmonary embolus leading to a good outcome.
authors.affiliation: Midwest Cardiovascular Research Foundation, IA, USA Cardiovascular Medicine, PC, IA and IL, USA Genesis Heart Institute, IA, USA shammas@mchsi.com.
authors.forename: N W
authors.initials: NW
authors.lastname: Shammas
authors.affiliation: Cardiovascular Medicine, PC, IA and IL, USA Genesis Heart Institute, IA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Padaria
authors.affiliation: Genesis Heart Institute, IA, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ahuja
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D003131:Combined Modality Therapy; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D061185:Mechanical Thrombolysis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D000069552:Rivaroxaban / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014464:Ultrasonic Therapy; D018084:Ultrasonography, Interventional
chemical_list: D011994:Recombinant Proteins; D006493:Heparin; D000069552:Rivaroxaban; D010959:Tissue Plasminogen Activator
keywords: Ultrasound-assisted lysis; pulmonary embolus; pulmonary hypertension; right atrial thrombus; right ventricular strain; tissue plasminogen activator