title: Comparison between systemic and catheter thrombolysis in patients with pulmonary embolism.
abstract: BACKGROUND
  Although systemic thrombolysis (ST) or catheter-directed therapy (CDT) is performed in patients with acute massive or submassive pulmonary embolism (PE), clinical data comparing between both therapies remain limited. We compared clinical outcomes between ST and CDT in patients with acute massive and submassive PE.
  
  
  METHODS
  From January 2005 to June 2015, clinical outcomes of patients with acute massive or submassive PE receiving ST or CDT were evaluated and compared retrospectively.
  
  
  RESULTS
  Of 72 patients, 44 were treated with ST; and 28, with CDT. The mean age was 63.9 ± 17 years old. The proportion of male sex was higher in patients receiving CDT compared to that with ST (46.4% vs 20.5%; P = .02). Half of patients presented with massive PE, and cardiac arrest occurred in 11 patients (15.3%). No difference was observed between the 2 groups with respect to 7-day mortality (13.6% in ST vs 10.7% in CDT), inhospital mortality (13.6% in ST vs 14.3% in CDT), and major bleeding complication (16.7% in ST vs 16.7% in CDT). Cardiac arrest (odds ratio, 6.286; 95% confidence interval, 1.081-36.555; P = .041) was associated with 14-day mortality.
  
  
  CONCLUSIONS
  Similar clinical outcomes were shown between ST and CDT in patients with acute massive or submassive PE.
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea.
authors.forename: Jung-Wan
authors.initials: JW
authors.lastname: Yoo
authors.affiliation: Department of Radiology, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea.
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea.
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea.
authors.forename: Yu Ji
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea.
authors.forename: Jong Deog
authors.initials: JD
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea. Electronic address: hochkim@gnu.ac.kr.
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000368:Aged; D002404:Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents