Efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism
10.3760/cma.j.issn.0253-3758.2018.12.008
- VernacularTitle: 经皮导管介入术治疗急性肺栓塞的初步探讨
- Author:
Jianfei CHEN
1
;
Yaoming SONG
;
Jun JIN
;
Shiyong YU
;
Shizhu BIAN
;
Ping LI
;
Lan HUANG
Author Information
1. Department of Cardiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
- Publication Type:Journal Article
- Keywords:
Pulmonary embolism;
Risk stratification;
Catheter-directed interventional therapy
- From:
Chinese Journal of Cardiology
2018;46(12):972-975
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE).
Methods:PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed.
Results:The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE.
Conclusion:The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.
