Ultrasound-Accelerated Thrombolysis in High-Risk Perioperative Pulmonary Embolism: Two Case Reports and Review of Literature Article Swipe
Götz Schmidt
,
Fabian Edinger
,
Christian Koch
,
Matthias Wolff
,
Christoph Biehl
,
Rüdiger Hörbelt
,
Michael Sander
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-82629/v1
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-82629/v1
Background: Treatment of high-risk pulmonary embolism (PE) in perioperative patients remains challenging. Systemic thrombolysis is associated with a high risk of major bleedings and intracranial haemorrhage. High mortality rates are reported for open pulmonary embolectomy. Therefore, postoperative surgical patients may benefit substantially from catheter-directed ultrasound-accelerated thrombolysis (USAT). Case summary: We report two cases of high-risk perioperative PE. Both patients developed severe haemodynamic instability leading to cardiac arrest. After the implantation of a veno-arterial extracorporeal membrane oxygenation (ECMO), they were both successfully treated with USAT. Adequate improvement of right ventricular function was achieved; thus, ECMO could be successfully weaned after three and four days, respectively. Both patients showed favourable outcomes and could be discharged to rehabilitation. Discussion: The current European guideline on treatment of PE offers no specific therapies for perioperative patients with high-risk PE. However, systemic thrombolysis is often excluded due to the perioperative setting and the risk of major bleeding. Catheter-directed thrombolysis was shown to utilise less thrombolytic agent while obtaining comparable thrombolytic effects. The risk for major bleeding (including intracranial haemorrhage) is also significantly lowered. Conclusion: Further prospective randomised controlled trials are necessary to determine the value of USAT treatment of high-risk PE in perioperative patients.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.21203/rs.3.rs-82629/v1
- https://www.researchsquare.com/article/rs-82629/v1.pdf?c=1601514714000
- OA Status
- green
- Cited By
- 1
- References
- 37
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4231578738
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4231578738Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.21203/rs.3.rs-82629/v1Digital Object Identifier
- Title
-
Ultrasound-Accelerated Thrombolysis in High-Risk Perioperative Pulmonary Embolism: Two Case Reports and Review of LiteratureWork title
- Type
-
preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2020Year of publication
- Publication date
-
2020-09-30Full publication date if available
- Authors
-
Götz Schmidt, Fabian Edinger, Christian Koch, Matthias Wolff, Christoph Biehl, Rüdiger Hörbelt, Michael SanderList of authors in order
- Landing page
-
https://doi.org/10.21203/rs.3.rs-82629/v1Publisher landing page
- PDF URL
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https://www.researchsquare.com/article/rs-82629/v1.pdf?c=1601514714000Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.researchsquare.com/article/rs-82629/v1.pdf?c=1601514714000Direct OA link when available
- Concepts
-
Thrombolysis, Pulmonary embolism, Medicine, Perioperative, Ultrasound, Radiology, Cardiology, Intensive care medicine, Internal medicine, Myocardial infarctionTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
- Citations by year (recent)
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2022: 1Per-year citation counts (last 5 years)
- References (count)
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37Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W2052960256, https://openalex.org/W2140707981, https://openalex.org/W2971121646, https://openalex.org/W2003812647, https://openalex.org/W2943896797, https://openalex.org/W2063458984, https://openalex.org/W1968098708, https://openalex.org/W2301761598, https://openalex.org/W2019242730, https://openalex.org/W2094155329, https://openalex.org/W2110112924, https://openalex.org/W2073284581, https://openalex.org/W3011371150, https://openalex.org/W2752436070, https://openalex.org/W2136958487, https://openalex.org/W1141106418, https://openalex.org/W86398073, https://openalex.org/W2587769491, https://openalex.org/W2171716470, https://openalex.org/W2792215874, https://openalex.org/W1905914871, https://openalex.org/W2588599139, https://openalex.org/W2123167192, https://openalex.org/W2027653806, https://openalex.org/W2061224978, https://openalex.org/W2905689888, https://openalex.org/W2058712976, https://openalex.org/W2145404820, https://openalex.org/W2884331333, https://openalex.org/W2011611174, https://openalex.org/W1970103817, https://openalex.org/W2605684272, https://openalex.org/W2774505235, https://openalex.org/W2033602864, https://openalex.org/W2739100376, https://openalex.org/W2755049322, https://openalex.org/W2619477097 |
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