Tratamento do tromboembolismo pulmonar maciço por fragmentação percutânea do trombo

Abstract

SummaryObjectives: To evaluate the safety and efficacy of percutaneous thrombus fragmentation (PTF) for massive pulmonary embolism (PE) in patients with contraindications to the administration of thrombolytics. Conclusion: The lack of adverse complications related to the procedure, proves that PTF is safe. The improvement in Sat O 2 , WI, PAP, SBP and RVF in 90% of the cases demonstrates the efficacy of the procedure, indicating that it is an alternative treatment for massive PE in patients with contraindications for the administration of systemic thrombolytics. Methods

Tratamento de tromboembolismo pulmonar por aspiração percutânea do trombo: relato de caso

“…The PE is an important cause of morbidity and mortality in the general population, with an estimated incidence of 0.5 per 1,000 people 1,6 . According to the extension and duration of the blockage, it may be categorized as acute, subacute and chronic.…”

“…Nearly 11% of the PE untreated patients have a fatal outcome in the first hour after the disease onset 7 . Until the third month, 15% of the patients die 1,6 and 4% of the acute cases develop secondary pulmonary hypertension 8 . With regard to PE with cardiogenic shock, the mortality rate reaches 70% in some studies 1 .…”

“…Until the third month, 15% of the patients die 1,6 and 4% of the acute cases develop secondary pulmonary hypertension 8 . With regard to PE with cardiogenic shock, the mortality rate reaches 70% in some studies 1 . The prevention of this disease must be done, but, after its establishment, it should be promptly diagnosed and treated.…”

“…Pulmonary embolism (PE) is the blockage of pulmonary arteries or their branches by a thrombus that often originates in the deep venous system, breaks free, and, by crossing the right cavities of the heart, reaches the pulmonary circulation 1,2 . Acute PE is associated with high morbidity and mortality rates, especially during hospitalization 3 .…”

“…Acute PE is associated with high morbidity and mortality rates, especially during hospitalization 3 . Some records indicate that the hospital mortality rate for patients with massive PE is above 30% 1 . The main mechanism that causes deaths is right ventricular dysfunction, and patients' survival depends on rapid recanalization of pulmonary arteries and on reduction of right ventricular ejection fraction resistance 4 .…”