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Catheter-Based Therapies Decrease Mortality in Patients With Intermediate and High-Risk Pulmonary Embolism: Evidence
Arkadiusz Pietrasik1, Aleksandra Gąsecka1, Łukasz Szarpak2,3
11st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Frontiers in Cardiovascular Medicine
|July 5, 2022
Summary
Catheter-directed therapies (CDT) reduce mortality and complications in pulmonary embolism (PE) patients compared to systemic thrombolysis (ST). This meta-analysis found lower 30-day mortality and fewer bleeding events with CDT.
Area of Science:
- Cardiology
- Interventional Radiology
- Pulmonary Medicine
Background:
- Pulmonary embolism (PE) poses significant mortality risks.
- Catheter-directed therapies (CDT) offer an alternative to systemic thrombolysis (ST).
- The comparative benefit of CDT versus ST in PE remains unclear.
Approach:
- Systematic review and meta-analysis of 11 studies.
- Included 65,589 adult PE patients comparing CDT and ST.
- Primary endpoint: 30-day mortality; Secondary endpoints: complications, resource use, length of stay.
Key Points:
- CDT was associated with significantly lower 30-day mortality (7.3% vs. 13.6%).
- CDT demonstrated reduced rates of myocardial injury, cardiac arrest, stroke, and major bleeding.
- Extracorporeal life support was used more frequently with CDT.
Conclusions:
- Catheter-directed therapies may decrease mortality in intermediate-high and high-risk PE patients.
- CDT is associated with fewer complications, including major bleeding, compared to ST.
- Hospital resource utilization and length of stay were similar between CDT and ST.
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