Pulmonary embolectomy: Review and current status

Sautter, Richard D.; Myers, Wayne L.; Ray, Jefferson F.; Wenzel, Frederick J.

doi:10.1016/s0033-0620(75)80013-2

Cited by 39 publications

(5 citation statements)

References 91 publications

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“…5,13,14 In the reported cases, peripherally dislodged emboli or thrombotic material distal to the emboli could not be completely removed by conventional methods. By using an inflatable balloon catheter, it appeared possible to extract thrombotic material even from segmental ramifications of the pulmonary artery.…”

Section: Methodsmentioning

confidence: 89%

Balloon Catheter Extraction of Pulmonary Emboli

Semb¹,

Storstein²,

Lilleaasen³

1981

Vascular Surgery

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Section: Methodsmentioning

confidence: 89%

Balloon Catheter Extraction of Pulmonary Emboli

Semb¹,

Storstein²,

Lilleaasen³

1981

Vascular Surgery

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“…In contrast to other studies, 164 Gulba et al 169 favored the surgical approach in the treatment of patients with acute PE and circulatory failure. Their data suggest a higher death rate, an increased risk of major hemorrhage, and an increased recurrence rate of PE in patients treated with thrombolysis, but they also underline the importance of thrombolytic agents, especially when surgery is unavailable.…”

Section: Surgical Management Of Acute Pementioning

confidence: 91%

“…Some claim that there are no indications for the operation, because few patients survive long enough for the procedure to be undertaken, and those who do, are likely to survive anyway if they receive intensive conventional therapy. 164 Other authors have suggested that pulmonary embolectomy should be considered more often. 165,166 However, based on current data, the only patients with massive PE in whom acute embolectomy seems to be advisable are those who have absolute contraindications to anticoagulant or thrombolytic therapy (recent major operations, cerebrospinal trauma, active hemorrhage), patients in whom thrombolytic therapy has proven to be ineffective in restoring hemodynamic integrity, and those who have sustained cardiac arrest.…”

Section: Surgical Management Of Acute Pementioning

confidence: 99%

Pulmonary Embolism. II. Diagnosis and Treatment

Janata-Schwatczek

Weiß²,

Riezinger³

et al. 1996

Semin Thromb Hemost

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Pulmonary embolism is an often underestimated, underdiagnosed, and undertreated disease. As symptoms and signs of pulmonary embolism are nonspecific, the diagnosis still remains a challenge to the attending physician. Diagnostic and therapeutic procedures depend on the clinical presentation of the patient. First we must suspect pulmonary embolism and consider its likelihood in the presence of a number of clinical signs and symptoms. Once pulmonary embolism is suspected, heparin should be administered. Additional basic support is mandatory if required. If the patient's hemodynamic situation is stable, available preferable noninvasive diagnostic options should be considered to confirm or rule out the diagnosis of venous thromboembolism before further administration of anticoagulant or thrombolytic agents. If the patient's status has deteriorated, bedside diagnostic techniques should be applied to reinforce the suspicion or establish the diagnosis. To restore pulmonary perfusion more rapidly than conventional anticoagulation is suspected to do, several dosing regimens of thrombolytic agents are proposed, with recent interest in short-term thrombolysis and bolus lysis with urokinase or recombinant tissue plasminogen activator. If thrombolysis fails or is contraindicated, catheter embolectomy or surgical embolectomy is indicated. The main therapy is prevention. In this article, clinical assessment, imaging techniques, and therapeutic options described in the published literature are discussed and clinical experiences of an emergency department with a noninvasive diagnostic approach are described.

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“…Intubation and institution of mechanical ventilation should be employed as needed to support respiratory failure. Pulmonary embolectomy has been considered an acceptable mode of therapy for acute massive PE by some [ 112 1; but others have emphasized that there are no indications for such an operation [113]. Although many patients die from PE before surgical embolectomy would be feasible, some deteriorate hours after the initial episode, suggesting that surgery may occasionally be appropriate (1141.…”

Section: Thrombolytic Therapy In Venous Thromboembolismmentioning

confidence: 99%

Pulmonary Embolism in the Intensive Care Unit

Tapson

Fulkerson

1994

J Intensive Care Med

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Tapson VF, Fulkerson WJ. Pulmona~y embolism in the intensive care unit. J Intensive Care hled 1994;9:119-131.Deep venous thrombosis (DvT) and pulmonary embolism (PE) result in significant morbidity and mortality in hospitalized patients. There are more than 250,000 patients hospitalized with DVT or PE annually [ l]. Autopsy studies demonstrated a significantly higher incidence of PE than is clinically recognized and it appears likely that the true prevalence of venous thromboembolism (VTE) in the United States is greater than 600,000 cases per year [1-3]. As many as 50,000 to 200,000 deaths per year may result [3,4]. Fatal PE or PE serving as a major contributing factor to mortality are discovered in approximately 7 to 9% of autopsied patients [2]. This entity has been termed the ??lost coi?ii?iotz lethal pidniotiay disease in adults seen at iieci-opy in the gem eral boqifalpoptdarion [5]. Despite new diagnostic and therapeutic modalities and emphasis on prophylaxis, the death rate remains substantial (61. The true incidence of VTE in patients in the intensive care unit (ICU) is poorly documented, but it appears to be common and underdiagnosed [7,8]. Considering the wide array of underlying medial or surgical diseases present in the ICU, combined with prolonged immobility, the incidence is almost certainly high. Thus, a high index of suspicion and a low threshold for diagnostic evaluation and prophylaxis for VTE is prudent in ICU patients. Risk FactorsThe pathogenesis of VTE as proposed by Virchow is based on several potential initiating events, including venous injury, stasis, and hypercoagulability. Certain well-defined risk factors are associated with VTE (Table 1). Frequently, more than one risk factor is present in ICU patients, and knowledge of these risk factors provides the rationale for both prophylaxis and diagnosis. A prior history of thromboembolic disease predicts a significant risk of recurrence in hospitalized patients. Surgical patients with a previous history of thromboembolism may than 50% when monitored with '*jI-fibrinogen leg scanning [9]. Surgery places a patient at substantially increased risk. A meta-analysis of general surgery patients not receiving pharmacological O r mechanical prophylaxis and undergoing '251-fibrinogen scanAddress rorrespondence to Dr Tapson, Division of Allergy, pulmonary and Critial Care, Duke University Aledial Center, BOX 31175, D u r h m , NC 27710. have a frequency of postoperative DVT of

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Pulmonary embolectomy: Review and current status

Cited by 39 publications

References 91 publications

Balloon Catheter Extraction of Pulmonary Emboli

Balloon Catheter Extraction of Pulmonary Emboli

Pulmonary Embolism. II. Diagnosis and Treatment

Pulmonary Embolism in the Intensive Care Unit

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