Catheter-directed therapy for acute pulmonary embolism: results of a multicenter national registry.
Rev Esp Cardiol (Engl Ed)
; 77(2): 138-147, 2024 Feb.
Article
em En, Es
| MEDLINE
| ID: mdl-37354942
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Catheter-directed therapy (CDT) for acute pulmonary embolism (PE) is an emerging therapy that combines heterogeneous techniques. The aim of the study was to provide a nationwide contemporary snapshot of clinical practice and CDT-related outcomes.METHODS:
This Investigator-initiated multicenter registry aimed to include consecutive patients with intermediate-high risk (IHR) or high-risk (HR), acute PE eligible for CDT. The primary outcome of the study was in-hospital all-cause death.RESULTS:
A total of 253 patients were included, of whom 93 (36.8%) had HR-PE, and 160 (63.2%) had IHR-PE with a mean age of 62.3±15.1 years. Local thrombolysis was performed in 70.8% and aspiration thrombectomy in 51.8%, with 23.3% of patients receiving both. However, aspiration thrombectomy was favored in the HR-PE cohort (80.6% vs 35%; P<.001). Only 51 patients (20.2%) underwent CDT with specific PE devices. The success rate for CDT was 90.9% (98.1% of IHR-PE patients vs 78.5% of HR-PE patients, P<.001). In-hospital mortality was 15.5%, and was highly concentrated in the HR-PE patients (37.6%) and significantly lower in IHR-PE patients (2.5%), P<.001. Long-term (24-month) mortality was 40.2% in HR-PE patients vs 8.2% in IHR-PE patients (P<.001).CONCLUSIONS:
Despite the high success rate for CDT, in-hospital mortality in HR-PE is still high (37.6%) compared with very low IHR-PE mortality (2.5%).Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
/
Fibrinolíticos
Idioma:
En
/
Es
Ano de publicação:
2024
Tipo de documento:
Article