PT  - JOURNAL ARTICLE
AU  - Asli Gorek Dilektasli
AU  - Ezgi Demirdogen Cetinoglu
AU  - Nilufer Aylin Acet
AU  - Cuneyt Erdogan
AU  - Ahmet Ursavas
AU  - Funda Coskun
AU  - Ercument Ege
TI  - Comparision of catheter-directed therapy with the systemic thrombolysis for the treatment of acute pulmonary embolism with right ventricular dysfunction
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2305
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2305.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2305.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BACKGROUND:Cathater-directed therapy(CDT)has been considered as an alternative to systemic thrombolysis(ST) in acute pulmonary embolism(PE) in the presence of contraindications for ST.We aimed to evaluate the efficacy and safety of CDT compared to SIT in acute PE management with right ventricular dysfunction(RVD).MATERIAL-METHODS:Acute PE patients with RVD diagnosed between 2007-2013 treated by CDT were included.Afterwards PE patients treated by CDT were matched by age,sex,mean pulmonary artery pressure,and shock index at admission with a PE patient whom recieved ST.The primary,secondary and tertiary outcomes were mortality,complications and the change in haemodynamic parameters in thefirst 24 hours.RESULTS:Thirty-two acute PE patients(58.5±15.3 years old)were included.Seventeen(53%)and fifteen(47%)of the study group were diagnosed as massive and submassive PE, respectively. CDT was performed in six(40%)patients with massive PE and nine(60%)with submassive PE. All-cause mortality,major and minor bleeding complications did not differ among CDT and ST groups(p>0,05). Haemodynamic parameters were stabilized in 93% of CDT group and76.5% of the ST group in thefirst 24 hours(p>0,05).24th hour systolic blood pressure(116±13mmHg vs.110±23 mmHg,p=0.078)and diastolic blood pressure(72±4mmHg vs.67±9 mmHg,p=0.017)were found to be higher while heart rate(88±16mmHg vs.90±10 mmHg,p=0.068)were found to be lower in the CDT group.CONCLUSION:CDT is a safe and effective treatment option for acute PE with RVD.It should be considered as a first-line treatment for patients having contraindications for ST with acute PE and RVD in experienced centers.