title: Ultrasound-Assisted Catheter-Directed Thrombolysis in High-Risk and Intermediate-High-Risk Pulmonary Embolism: Results From a Single-Center Cohort.
abstract: We present our single-center results on ultrasound-assisted thrombolysis (USAT) in patients with pulmonary embolism (PE) at intermediate high risk (IHR) and high risk (HR). Our study consisted of 75 patients with PE who underwent USAT (60 at IHR and 15 at HR). The median time delay from symptoms to USAT was 5 days. Ultrasound-assisted thrombolysis resulted in improvements in tricuspid annular plane systolic excursion; pulmonary artery (PA) systolic and mean pressures; Qanadli score; right to left ventricle diameter ratio and right to left atrial diameter ratio; and diameters of main, right, and left PA regardless of the baseline risk status ( P < .0001 for all). Death was documented in 4 patients, and major and minor bleeding were noted in 2 and 5 of the patients, respectively. No PE-related event was noted during postdischarge follow-up period of median 310 days. Our study revealed that USAT facilitates the resolution of PA thrombotic burden, recovery of pulmonary hemodynamics, and right heart functions with acceptable rates of procedure-related complications in patients with PE, irrespective of the IHR or HR status.
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Cihangir
authors.initials: C
authors.lastname: Kaymaz
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Öztürk
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Akbal
authors.affiliation: 2 Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey.|3 Department of Biostatistics, Ataturk University Medical School, Erzurum, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Tanboğa
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yılmaz
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Nertila
authors.initials: N
authors.lastname: Poçi
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sevim
authors.initials: S
authors.lastname: Türkday
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Aykun
authors.initials: A
authors.lastname: Hakgör
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Yildiz
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Aktemur
authors.affiliation: 1 Department of Cardiology, Koşuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Özdemir
authors.affiliation: 4 Department of Cardiology, Democritus University Medical School, Thrace, Greece.|5 Centre for Thrombosis and Hemostasis, University Medical Centre, Johannes Gutenberg University of Mainz, Mainz, Germany.
authors.forename: Stavros
authors.initials: S
authors.lastname: Konstantinides
mesh_terms: D002404:Catheterization / Q000379:methods*; D003287:Contrast Media; D004452:Echocardiography; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: fibrinolytic; pulmonary embolism; ultrasound-assisted treatment