Transcatheter thrombectomy combined with catheter-directed thrombolysis for treating acute medium-high and high risk pulmonary thromboembolism
10.13929/j.issn.1672-8475.2024.01.001
- VernacularTitle:经导管抽吸血栓联合接触性溶栓治疗急性中-高危与高危肺血栓栓塞
- Author:
Jianshan SHI
1
;
Yanfen LI
;
Minglin ZHANG
;
Gang SUN
;
Guiyun JIN
Author Information
1. 海南医学院第一附属医院介入血管外科,海南海口 570102
- Keywords:
pulmonary embolism;
thrombolytic therapy
- From:
Chinese Journal of Interventional Imaging and Therapy
2024;21(1):2-6
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of transcatheter thrombectomy combined with catheter-directed thrombolysis(CDT)for treating acute medium-high and high risk pulmonary thromboembolism(PTE).Methods After placement of inferior vena cava filter,transcatheter thrombectomy combined with CDT were performed in 28 patients with acute medium-high or high risk PTE.After treatment,clinical symptoms improved or not was assessed,and interventional related complications were recorded.The outcomes of arterial blood gas analysis,coagulation function,blood routine test,pulmonary artery pressure(PAP)and right ventricular diameter/left ventricular diameter(RV/LV)were compared before and 72 h after treatment.Regular follow-up was performed,then PAP and the clearance of pulmonary arterial thrombosis were observed 1,3,6 months and 1 year after treatment during follow-up.Results Among 28 cases,significant improvement of clinical symptoms achieved in 26 cases after treatment,while 2 patients died of respiratory failure.Puncture site bleeding occurred in 4 cases and improved after conservative treatment.Compared with those before treatment,among 26 survived patients,blood pH,arterial oxygen pressure,fibrin degradation products and D-dimer increased while the heart rate,N-terminal pro-B-type natriuretic peptide,PAP and RV/LV decreased 72 h after treatment(all P＜0.05).During follow-up,compared with those before treatment,PAP decreased,while the clearance rate of pulmonary thrombosis increased 1,3,6 months and 1 year after treatment(all P＜0.05).No active bleeding nor recurrence of PTE happened.Conclusion Transcatheter thrombectomy combined with CDT was safe and effective for treating acute medium-high and high risk PTE.
