We assessed the efficacy of thrombolysis in avoiding long-term complications.
Notes of patients thrombolysed for PE in the 2-year period were reviewed. The initial CTPA and echocardiogram results before thrombolysis were compared to the results of follow up imaging repeated after 6 months.
Twenty-two patients were thrombolysed for PE. 14 patients had sub-massive PE and 8 patients had massive PE. The right ventricle (RV) was dilated on pre-thrombolysis echocardiogram in 16 patients.
On follow up echocardiography all patients with massive PE (6 studies) had a normal RV size, with pulmonary artery pressures (PAP) of 29mmHg. Follow up echocardiography of patients with submassive PE (13 studies) showed 11 patients with a normal RV, with PAP of 28 mmHg.
References
- Thomas DC, Limbrey M. Thrombolysis of acute PE patients reduces subsequent development of CTEPH. Thorax 2012; 67:Suppl 2 A125.
- Howard LS. Thrombolytic therapy for sub- massive pulmonary embolus? Pro viewpoint. Thorax 2014; 69(2): 103.
- Kline, J A, K E Nordenholz, et al. Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicentre doublebline, placebo controlled randomised trial. Journal of thrombosis and haemostasis: JTH 2014; no.4. doi:10.1111/jth.12521
- Sharma GV, Folland ED, Mcintyre KM, et al. Long term benefit of thrombolytic therapy in patients with pulmonary embolism. Vasc Med 2000; 5(2): 91–5.
- British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58(6):470–83.
- Sharifi M, Bay C, Skrocki L, et al. Moderate Pulmonary Embolism Treated With Thrombolysis (from the “MOPETT” Trial). The American Journal of Cardiology 2013; 111(2): 273–77.
- Barco S, Russo M, Vicaut E, et al. Incomplete echocardiographic recovery at 6 months predicts long-term sequelae after intermediate-risk pulmonary embolism. A post-hoc analysis of the Pulmonary Embolism Thrombolysis (PEITHO) trial. Clinical Research in Cardiology 2018; 108(7): 772-8.
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