Ultrasound Accelerated Thrombolysis May Be an Effective and Safe Treatment Modality for Intermediate Risk/Submassive Pulmonary Embolism

Int Heart J. 2016;57(1):91-5. doi: 10.1536/ihj.15-271. Epub 2015 Dec 17.

Abstract

Pulmonary embolism (PE) is a potentially life-threatening condition and the fact that 90% of PE originate from lower limb veins highlights the significance of early detection and treatment of deep vein thrombosis. Massive/high risk PE involving circulatory collapse or systemic arterial hypotension is associated with an early mortality rate of approximately 50%, in part from right ventricular (RV) failure. Intermediate risk/submassive PE, on the other hand, is defined as PE-related RV dysfunction, troponin and/or B-type natriuretic peptide elevation despite normal arterial pressure. Without prompt treatment, patients with intermediate risk PE may progress to the massive category with a potentially fatal outcome. In patients with PE and right ventricular dysfunction (RVD), in hospital mortality ranges from 5% to 17%, significantly higher than in patients without RVD.

MeSH terms

  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / therapy*
  • Retrospective Studies
  • Risk Factors
  • Thrombolytic Therapy / methods*
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome
  • Ultrasonic Therapy / methods*
  • Ventricular Dysfunction, Right / etiology
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Dysfunction, Right / therapy
  • Ventricular Function, Right

Substances

  • Tissue Plasminogen Activator