One Year Follow-Up of Pharmacomechanical Therapy in Patients With Acute Pulmonary Embolism

Abstract

BACKGROUND The aim of the study is to evaluate the efficacy and safety of thrombectomy with catheter-directed thrombolysis in patients with massive or submassive Pulmonary Embolism (PE) and to study the clinical profile of these patients at one year follow up. MATERIALS AND METHODS This was a single centered prospective study that included 15 patients with acute massive or submassive pulmonary embolism who underwent pulmonary thrombectomy with catheter-directed thrombolysis (intrapulmonary half-dose reteplase) between January 2013 and March 2015. The patients were followed up to one year. RESULTS Of total 15 patients, 80% of patients were females. Five and ten patients had massive and submassive PE, respectively. At one year follow-up, there was improvement in systolic blood pressure, heart rate, respiratory rate, peripheral capillary oxygen saturation, pulmonary arterial pressure and right ventricular function in patients with massive as well as submassive PE. One year mortality rate was 6.6% and there was one major and one minor incidence of bleeding. Haemodynamic improvement was observed in 93.3% patients. CONCLUSION The study concludes that pharmacomechanical therapy, i.e. the use of pigtail catheter followed by intrapulmonary half-dose thrombolysis using bolus reteplase results in favourable one year outcomes in patients with massive or high-risk submassive pulmonary embolism.