Early interventional therapy for acute massive and submassive pulmonary embolism / 中华普通外科杂志

ABSTRACT

Objective To evaluate interventional therapy for acute massive and submassive pulmonary embolism.Methods From June 2011 to June 2014.53 patients were enrolled and divided into group massive pulmonary embolism (MPE,n =16) and group submassive pulmonary embolism (SPE,n =37),both receiving catheter thrombectomy + contact thrombolysis within 12 hours after diagnosis.Preand post-interventional measures were assessed,including mean pulmonary arterial pressure (MPAP),cardiac biomarkers,tricuspid regurgitation,right ventricular (RV) dilatation,and massive hemorrhage within 72 hours.Patients were followed up for 6 months for the occurrence of chronic thromboembolic pulmonary hypertension.Results In all 53 patients were successfully completed catheter thrombectomy +contact thrombolysis,the mean pulmonary artery pressure in group MPE decreased from (47 ± 6)mmHg to (34 ± 4) mmHg (P ＜ 0.05),and in group SPE decreased from (44.2 ± 1.5) mmHg to (31.4 ± 6.2) mmHg (P ＜ 0.05).The ventriculus dexter disfunction was alleviated in 78.4％ patient after therapy.Overall 1.9％ patients suffered from massive hemorrhage,(0) in group MPE,and (2.7％)in group SPE.The incidence of chronic thromboembolic pulmonary hypertension during 6 moths follow up was 0.Conclusion Early interventional therapy for massive and submassive pulmonary embolism decreased pulmonary artery pressure,relieved right ventricular dysfunction,reduced bleeding complications and the incidence of chronic thromboembolic pulmonary hypertension.