Author + information
- Elias A. Iliadis,
- Nayan Desai,
- John Trujillo,
- Xin Zhang,
- Simon Topalian,
- Brian Corbett and
- Janah Aji
Background: Pulmonary Embolism (PE) continues to pose a significant diagnostic and therapeutic challenge. Newer technology such as catheter directed thrombolysis with ultrasonic therapy (UACDT) has been suggested as a treatment modality for submassive PE. However, appropriate timing of procedure has not been fully defined.
Aim: to evaluate the timing of UACDT for pulmonary embolism with respect to efficacy as measured by echocardiographic parameters and clinical safety.
Methods: Consecutive patients with submassive or massive PE who underwent UACDT from 2014-2016. Demographic, procedural, echocardiographic including Right ventricle Left ventricle ratio (RV/LV) and safety outcomes data were analyzed with respect to timing of procedure; less than or greater than 72 hours of symptoms prior to procedure.
Results: 24 patient were analyzed with 15 patient less than 72 hours (L72) and 9 patients greater than (G72). L72 patients were younger (54 v 59 yrs) while G72 patients had more prior DVT (33 v 67%). G72 patients experienced with more chest pains (36 v 78%), more dyspnea (60 v 100%) while L72 patients presented with syncope more often (40 v 22%). Time to procedure was 48 hours for L72 group while 220 hours for G72. The groups were comparable with respect to PE type, catheters placed and hemodynamic measurements. Both groups had comparable recovery in Tricuspid valve acceleration times while L72 group had greater RV LV ratio improvement (.31 v .26). There was no difference in bleeding, procedural complications or arrhythmia. The length of stay was greater with the L72 group (10 v 6 days)
Conclusion: Our study suggest that the early treatment (less than 72 hours) with UACDT may be associated with greater improvement in RV LV ratio while no impact on safety. Larger registry studies may be needed to further define patient populations who benefit the greatest and limit the adverse effects.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Updates on Pulmonary Embolism Management in 2017
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1141-008
- 2017 American College of Cardiology Foundation