在现实肺栓塞患者群体中以导管导向的机械吸血血栓切除术:一个多中心注册表
Sylwia Sławek-Szmyt1, Jakub Stępniewski2,3, Marcin Kurzyna4
1Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznan, Poland.
European heart journal. Acute cardiovascular care
|June 15, 2023
概括
导管导向机械血栓切除术 (CDMT) 为高风险肺栓塞 (PE) 提供了安全有效的治疗方法. 这项现实研究表明,CDMT可以改善PE患者的血液动力学,并具有可接受的安全性.
科学领域:
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
- 肺部医学 肺部医学
背景情况:
- 高 (HR) 和中高风险 (IHR) 肺栓塞 (PE) 与显著的早期死亡率和长期并发症有关.
- 对HR和IHR PE有效的治疗策略对于改善患者的治疗结果至关重要.
研究的目的:
- 为了评估与导管导向机械血栓切除术 (CDMT) 相关的临床结果和不良事件,在IHR和HR PE患者的真实世界人口中.
- 评估CDMT在治疗急性肺栓塞的安全性和有效性.
主要方法:
- 一项多中心,前性注册表研究招募了110名PE患者,他们在2019年至2022年期间接受了CDMT治疗.
- 在肺动脉中使用双边的8F Indigo系统进行CDMT.
- 安全终点包括设备/PE相关的死亡,严重出血和48小时内的不良事件;疗效终点集中在血液动力学改善和RV/LV比率变化.
主要成果:
- 该研究包括71.8%的IHR PE和28.2%的HR PE患者.
- CDMT显示出立即的血液动力学改善,包括系统性和平均肺动脉压的显著下降以及RV/LV比率.
- 安全性概况是可以接受的,主要出血率低 (1.8%),肺动脉损伤 (1.8%),缺血性中风 (0.9%). 在48小时内死亡率为5.5%.
结论:
- 导管导向机械血栓切除术 (CDMT) 似乎是中等高风险和高风险肺栓塞患者的可行治疗选择.
- 在PE患者中,CDMT可以导致显著的血液动力学改善.
- 在这个现实世界队列中,该程序与可接受的安全概况相关.
相关概念视频
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
15
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
15
01:29Venous Thrombosis III: Interprofessional Care
11
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
11
01:27Pulmonary Embolism III: Nursing Management
17
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
17
01:29Pulmonary Embolism I: Introduction
10
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
10
01:27Peripheral Artery Disease III: Interprofessional Care
13
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
13