title: Ultrasound Assisted Catheter Directed Thrombolysis in the Management of a Right Atrial Thrombus: A New Weapon in the Armamentarium?
abstract: Catheter related thrombosis (CRT) is a commonly encountered entity fraught with substantial risk for mortality secondary to various complications including pulmonary embolism (PE), tricuspid regurgitation, endocarditis, right sided heart failure, and cardiogenic and septic shock. CRT carries a mortality rate of 18% in hemodialysis patients and more than 40% in nonhemodialysis patients. Management strategies include systemic anticoagulation, systemic thrombolysis, surgical evacuation, and percutaneous retrieval with no established guidelines. Ultrasound assisted catheter directed thrombolysis emerges as promising modality with a relatively lower risk of hemorrhage compared to systemic thrombolysis. We report a case of a 75-year-old man with dialysis catheter related thrombosis without PE for which ultrasound assisted catheter directed thrombolysis was used successfully as an alternative therapy.
authors.affiliation: Internal Medicine Department, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Mohamed
authors.identifier: 0000-0002-8227-0463
authors.initials: M
authors.lastname: Shokr
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Ramanjit
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Internal Medicine Department, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Kevin
authors.identifier: 0000-0003-0977-1314
authors.initials: K
authors.lastname: Belgrave
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Arshad
authors.initials: A
authors.lastname: Javed
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Mahir
authors.initials: M
authors.lastname: Elder
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Shaun
authors.identifier: 0000-0001-7239-1192
authors.initials: S
authors.lastname: Cardozo
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Kaki