title: Surgical embolectomy versus thrombolytic therapy in the management of acute massive pulmonary embolism: Short and long-term prognosis.
abstract: OBJECTIVE
  Comparison between surgical embolectomy and thrombolytic therapy in patients suffering from acute massive pulmonary embolism (AMPE).
  
  
  BACKGROUND
  Prompt treatment of AMPE is necessary, although optimal management is a matter of debate.
  
  
  METHODS
  Patients with AMPE were assigned to either thrombolytic therapy or pulmonary surgical embolectomy. Early and late mortality, systolic pulmonary artery pressure (SPAP), right ventricular diameter (RVD) and bleeding complications were evaluated.
  
  
  RESULTS
  Seventy eight patients were treated with thrombolytic therapy and 30 patients underwent surgery. The difference between pre-intervention and third-day post-intervention in terms of RVD and SPAP was significantly greater in patients under surgical embolectomy (P < 0.001). There was a significant decline in RVD and SPAP in both groups during follow-up (P < 0.001). Mortality rate in the surgical embolectomy group was lower than the thrombolytic group although not significantly.
  
  
  CONCLUSIONS
  Early surgical treatment was associated with fewer complications in comparison to thrombolytic therapy.
authors.affiliation: Department of Cardiac Surgery, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Azari
authors.affiliation: Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ahmad Tashakori
authors.initials: AT
authors.lastname: Beheshti
authors.affiliation: Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Moravvej
authors.affiliation: Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Cardiology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: Bigdelul@mums.ac.ir.
authors.forename: Leila
authors.initials: L
authors.lastname: Bigdelu
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Salehi
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D017128:Embolectomy / Q000379:methods* / Q000401:mortality; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods* / Q000401:mortality
chemical_list: D005343:Fibrinolytic Agents
keywords: Echocardiography; Embolectomy; Pulmonary embolism; Thrombolytic therapy