ABSTRACT
Objective To: explore the efficacy and safety of interventional therapy for acute central pulmonary thromboembolism (PTE). Methods: Data of 72 patients with acute central PTE were retrospective analyzed. Interventional therapy of PTE were performed in all patients, then "one-stop" interventional therapy of deep venous thrombi of lower extremity were also performed in 65 patients. Complications during and after therapies were observed. Pulmonary artery pressure and D-dimer level were measured after interventional therapy and compared with those before treatment. The therapeutic effect was evaluated during follow-up. Results: No serious complication occurred. Heart rate arrhythmia and blood pressure rise during operation happened in 7 patients, blood leakage around thrombolytic catheter and subcutaneous ecchymosis at puncture point after operation were observed in 9 and 5 patients, respectively, all relieved after symptomatic treatment. Pulmonary artery pressure decreased significantly after interventional thrombectomy combined with catheter thrombolysis ([30.11±14.50]mmHg vs [40.22±17.58]mmHg, t=3.77, P<0.01), and D-dimer level also decreased significantly ([623.32±267.41]ng/ml vs [3 634.38±1 567.61]ng/ml, t=12.56, P<0.01) compared with those before treatment. The mean follow-up time was (15.92±5.22) months, and the total effective rate of interventional therapy of PTE was 97.22% (70/72). Complete thrombosis clearance or clearance rate of lower extremity higher than or equal to 95% (grade III) were observed in 61 patients (61/65, 93.85%) combined with PTE and deep venous thrombosis of lower extremities, while the rest 4 patients (4/65, 6.15%) had thrombosis clearance rate higher than or equal to 50% but lower than 95% (grade Ⅱ). Conclusion: Interventional therapy is safe and effective in treatment of acute central PTE, especially for patients with lower extremity deep venous thrombosis.