scholarly journals ADMISSION LACTATE AND OUTCOME IN INTERMEDIATE RISK (SUBMASSIVE) PULMONARY EMBOLISM

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A2336
Author(s):  
Soontharee Congrete ◽  
Mario Perez ◽  
Debapriya Datta
Keyword(s):  
Pulmonary Embolism ◽  
Intermediate Risk ◽  
Submassive Pulmonary Embolism

Advanced Management Options for Massive and Submassive Pulmonary Embolism

2016 ◽  
Vol 10 (1) ◽  
pp. 30 ◽  
Author(s):  
Sonika Malik ◽  
◽  
Anju Bhardwaj ◽  
Matthew Eisen ◽  
Sanjay Gandhi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Right Ventricular Dysfunction ◽  
Hemodynamic Instability ◽  
Adverse Outcomes ◽  
Intermediate Risk ◽  
Management Options ◽  
Vena Cava Filters ◽  
Submassive Pulmonary Embolism ◽  
Risk Patients

Pulmonary embolism (PE) is an important cause of morbidity and mortality and presents with significant diagnostic and therapeutic challenges. Clinical presentation ranges from mild, nonspecific symptoms to syncope, shock, and sudden death. Patients with hemodynamic instability and/ or signs of right ventricular dysfunction are at high risk for adverse outcomes and may benefit from aggressive therapy and support. Therapeutic anticoagulation is indicated in all patients in the absence of contraindications. Thrombolysis should be strongly considered in selected high- and intermediate-risk patients, either by systemic infusion or percutaneous catheter-directed therapy. Other therapeutic modalities, such as vena cava filters and surgical embolectomy, are options for patients who fail or cannot tolerate anticoagulation and/or thrombolysis. This article reviews the assessment and advanced management options for acute PE with focus on high- and intermediate-risk patients.

scholarly journals Low-dose thrombolysis for submassive pulmonary embolism

2021 ◽  
pp. jim-2021-001816
Author(s):  
Emine Serap Yilmaz ◽  
Oğuz Uzun
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Left Ventricular ◽  
Tissue Type ◽  
Bleeding Complications ◽  
Intermediate Risk ◽  
Risk Of Bleeding ◽  
Submassive Pulmonary Embolism ◽  
Half Dose

The role of thrombolysis in submassive pulmonary embolism (PE) is controversial due to the high risk of hemorrhage. This study aimed to evaluate the role of half-dose tissue-type plasminogen activator (rt-PA) in preventing death/hemodynamic decompensation in submassive (intermediate-risk) PE without increasing the risk of bleeding. In a prospective, non-randomized, open-label, single-center trial, we compared 50 mg rt-PA plus low molecular weight heparin (LMWH) with LMWH in submassive (intermediate-risk) PE. Eligible cases had confirmed pulmonary hypertension on echocardiography, and/or right ventricular cavity expansion and/or interventricular septal deviation on echocardiography, and/or right to left ventricular ratio equal to or greater than 0.9 mm on CT angiography. The primary outcome was death or hemodynamic decompensation within 7 and 30 days after treatment was given. The primary safety outcome was major extracranial bleeding or hemorrhagic stroke within 7 days. Seventy-six patients were included in the study. Total death/hemodynamic decompensation in the first 7 and 30 days was significantly less in the half-dose rt-PA group than in the LMWH group (p=0.028 and p=0.009, respectively). No significant differences were found between the two groups in terms of recurrent embolism and pulmonary hypertension at 6-month follow-up (p=1.000 and p=0.778). There was no intracranial hemorrhage in any of the patients. There were no statistically significant differences between the two groups in terms of major or minor bleeding complications. This trial showed half-dose rt-PA treatment in submassive (intermediate-risk) PE prevented death/hemodynamic decompensation in the first 7-day and 30-day period compared with LMWH treatment without increasing the risk of bleeding.

OP-161 Ultrasound Accelerated Thrombolysis May be an Effective and Safe Treatment Modality for Intermediate Risk/Submassive Pulmonary Embolism

2015 ◽  
Vol 115 ◽  
pp. S70-S71 ◽  
Author(s):  
Caglar Ozmen ◽  
Ali Deniz ◽  
Rabia Eker Akilli ◽  
Onur Sinan Deveci ◽  
Caglar Emre Cagliyan ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Treatment Modality ◽  
Intermediate Risk ◽  
Safe Treatment ◽  
Submassive Pulmonary Embolism

scholarly journals Ultrasound Accelerated Thrombolysis May Be an Effective and Safe Treatment Modality for Intermediate Risk/Submassive Pulmonary Embolism

2016 ◽  
Vol 57 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Caglar Ozmen ◽  
Ali Deniz ◽  
Rabia Eker Akilli ◽  
Onur Sinan Deveci ◽  
Caglar Emre Cagliyan ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Treatment Modality ◽  
Intermediate Risk ◽  
Safe Treatment ◽  
Submassive Pulmonary Embolism
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