Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism in the Third Trimester of Pregnancy

Amanda J Compadre; Maureen Kohi; R Peter Lokken; Sarah Blissett; Ian S Harris; Jennifer Lucero; Melissa G Rosenstein; Nasim C Sobhani

doi:10.1016/j.jaccas.2020.08.022

Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism in the Third Trimester of Pregnancy

JACC Case Rep. 2020 Oct 21;2(12):1899-1904. doi: 10.1016/j.jaccas.2020.08.022. eCollection 2020 Oct.

Authors

Amanda J Compadre¹, Maureen Kohi², R Peter Lokken², Sarah Blissett³, Ian S Harris³, Jennifer Lucero^{1

4}, Melissa G Rosenstein¹, Nasim C Sobhani¹

Affiliations

¹ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, School of Medicine, San Francisco, California.
² Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California-San Francisco, School of Medicine, San Francisco, California.
³ Division of Cardiology, Department of Internal Medicine, University of California-San Francisco, School of Medicine, San Francisco, California.
⁴ Department of Anesthesia and Perioperative Care, University of California-San Francisco, School of Medicine, San Francisco, California.

Abstract

A 37-year-old woman presented with chest pain and shortness of breath in the third trimester of pregnancy. Diagnostic imaging demonstrated a saddle pulmonary embolism, severe impairment of right ventricular function, and an extensive deep venous thrombus. She underwent catheter-directed thrombolysis with tissue plasminogen activator and delivered a healthy infant at term. (Level of Difficulty: Intermediate.).

Keywords: CDT, catheter-directed thrombolysis; CTA, computed tomography angiography; IV, intravenous; PA, pulmonary artery; PE, pulmonary embolism; POD, post-operative day; RV, right ventricle; UFH, unfractionated heparin; catheter-directed thrombolysis; pregnancy; thromboembolism.

Publication types

Case Reports