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Updated: Jun 1, 2025
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Catheter-directed therapy for pulmonary embolism in pediatrics: a systematic review and meta-analysis
Basel F Alqeeq1, Dina Essam Abo-Elnour2, Mohamed Rifai3
1Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine.
Insights
Catheter-directed therapy (CDT) shows promise for managing acute pulmonary embolism (PE) in children. While effective in resolving PE, further research is needed to confirm these findings in pediatric populations.
Area of Science:
- Pediatric Cardiology
- Interventional Pulmonology
- Vascular Medicine
Background:
- Acute pulmonary embolism (PE) is a rare but serious condition in children.
- Catheter-directed therapy (CDT) is an emerging treatment for massive/submassive PE.
Purpose of the Study:
- To systematically review the efficacy and safety of CDT for pediatric PE.
- To evaluate outcomes including resolution rates, mortality, recurrence, and complications.
Main Methods:
- Systematic literature search of electronic databases up to May 2024.
- Adherence to PRISMA guidelines.
- Quantitative analysis of 16 case reports/series involving 40 pediatric patients.
Main Results:
- Complete PE resolution occurred in 68% of patients.
- Mortality rate was 18%.
- PE recurrence was observed in 15%, and non-major bleeding in 46% of cases.
Conclusions:
- CDT is a potential therapeutic option for selected pediatric PE cases.
- Promising results warrant further investigation with well-conducted cohort studies.
Background:
Acute pulmonary embolism (PE) is a serious and potentially fatal condition that is relatively rare in the pediatric population. In patients presenting with massive/submassive PE, catheter-directed Therapy (CDT) presents an emerging therapeutic modality by which PE can be managed.
Methods:
Electronic databases were systematically searched through May 2024. This systematic review was performed in line with recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines and was registered in PROSPERO (Reg. no. CRD42024534229).
Results:
Sixteen case reports/series were included in the quantitative analysis with a total population of 40 children diagnosed with PE. Of them, 21 were females and 19 were males. Massive PE was diagnosed in 15 patients and submassive PE was diagnosed in 17 patients. Complete resolution of PE happened at a rate of 68% (95%CI = 46-80%). Mortality was encountered at a rate of 18% (95%CI = 0.7-36%). PE recurred after CDT at a rate of 15% (95%CI = 2-28%). Non-major bleeding complicated CDT at a rate of 46% (95%CI = 25-66%, p = 0.163).
Conclusion:
CDT can be utilized in the management of PE in children as a potential therapeutic option for selected patients. While the results of CDT interventions for pediatric PE are promising, further research -including well-conducted cohort studies- is required to validate those results.
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