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[Thrombus fragmentation and local lysis in extensive pulmonary embolisms]
K Rauber1, H E Riemann, C Franke
1Röntgenabteilung Innere Medizin der Kliniken der Justus-Liebig-Universität, Giessen.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|November 1, 1988
Summary
Local thrombolysis and embolus fragmentation effectively treated massive pulmonary embolism in two patients. This approach offers a promising alternative when systemic therapies fail.
Area of Science:
- Cardiology
- Vascular Medicine
- Interventional Radiology
Background:
- Massive pulmonary embolism (PE) poses a significant risk of mortality.
- Systemic thrombolytic therapy can be associated with bleeding complications.
- Limited treatment options exist for patients refractory to systemic therapy.
Observation:
- Two patients presented with massive pulmonary embolism.
- The first patient received local urokinase and mechanical fragmentation.
- The second patient, unresponsive to systemic urokinase, underwent local streptokinase and fragmentation.
Findings:
- Successful treatment with local urokinase and mechanical embolus fragmentation in the first patient.
- Complete lysis of pulmonary emboli achieved in the second patient using local streptokinase and fragmentation, following failed systemic therapy.
- Demonstrates the efficacy of localized treatment strategies.
Implications:
- Local thrombolysis combined with mechanical fragmentation is a viable treatment for massive PE.
- This approach may be particularly beneficial for patients who do not respond to or are contraindicated for systemic thrombolysis.
- Highlights the potential for minimally invasive interventional techniques in managing acute PE.