Journal of the Practice of Cardiovascular Sciences

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 4  |  Issue : 2  |  Page : 81--87

Catheter-based management of pulmonary embolism


Bishav Mohan1, Shibba Takkar Chhabra1, Amit Verma1, Hasrat Sidhu2, Abhishek Goyal1, Bhupinder Singh1, Naved Aslam1, Gurpreet Singh Wander1 
1 Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
2 Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Correspondence Address:
Dr. Bishav Mohan
Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab
India

Background: Pulmonary embolism (PE) is a major cause of mortality and morbidity. Forty-four percent of patients would not have gotten intravenous (IV) thrombolysis due to contraindications or delay. Catheter-directed thrombolysis with fragmentation has been shown to improve short-term and long-term outcomes in acute high-risk patients of pulmonary embolism. Methodology: Patients presented de nova with massive pulmonary embolism or with subacute pulmonary embolism. Some presented with failed thrombolysis from other centers. Results: Our experience from these patients shows that a policy of mechanical thrombus breakdown with a 5F multipurpose or pigtail catheter followed by a urokinase infusion can achieve satisfactory results. Fifty patients with acute were treated with thrombolysis with or without mechanical breakdown. There was 96% event-free survival. With subacute PE, using a mechanical breakdown plus IV thrombolysis, there was fall in pulmonary arterial pressures (PAPs) with 100% 6-month event-free survival. In seven patients with failed thrombolysis, this strategy leads to fall in PAPs and 100% survival at 2 years. Conclusions: Various catheter-based techniques are available which can be used in combination with thrombolysis to achieve good results. Surgery should be considered if the catheter-based techniques fail.


How to cite this article:
Mohan B, Chhabra ST, Verma A, Sidhu H, Goyal A, Singh B, Aslam N, Wander GS. Catheter-based management of pulmonary embolism.J Pract Cardiovasc Sci 2018;4:81-87


How to cite this URL:
Mohan B, Chhabra ST, Verma A, Sidhu H, Goyal A, Singh B, Aslam N, Wander GS. Catheter-based management of pulmonary embolism. J Pract Cardiovasc Sci [serial online] 2018 [cited 2020 Jan 27 ];4:81-87
Available from: http://www.j-pcs.org/article.asp?issn=2395-5414;year=2018;volume=4;issue=2;spage=81;epage=87;aulast=Mohan;type=0