Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results.

Autor: Colombo C; 1st Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Capsoni N; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Russo F; Interventional Cardiology Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy., Iannaccone M; Division of Cardiology, San Giovanni Bosco Hospital, 10154 Turin, Italy., Adamo M; Institute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy., Viola G; 1st Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Bossi IE; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Villanova L; 1st Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Tognola C; 4th Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Curci C; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Morelli F; Department of Interventional Radiology, Niguarda Cà Granda Hospital, 20142 Milan, Italy., Guerrieri R; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Occhi L; 4th Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Chizzola G; Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, 25121 Brescia, Italy., Rampoldi A; Department of Interventional Radiology, Niguarda Cà Granda Hospital, 20142 Milan, Italy., Musca F; 4th Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., De Nittis G; Cardiovascular Interventional Unit, Cardiology Department, S. Anna Hospital, 10126 Como, Italy., Galli M; Cardiovascular Interventional Unit, Cardiology Department, S. Anna Hospital, 10126 Como, Italy., Boccuzzi G; Division of Cardiology, San Giovanni Bosco Hospital, 10154 Turin, Italy., Savio D; Department of Interventional Radiology, San Giovanni Bosco Hospital, 10154 Turin, Italy., Bernasconi D; Bicocca Bioinformatics Biostatistics and Bioimaging (B4) Center, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Bicocca, Italy.; Department of Clinical Research and Innovation, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., D'Angelo L; 2nd Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Garascia A; 2nd Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Chieffo A; Interventional Cardiology Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy., Montorfano M; Interventional Cardiology Unit, IRCCS San Raffaele Hospital, 20132 Milan, Italy., Oliva F; 1st Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Sacco A; 1st Division of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2024 Jan 22; Vol. 13 (2). Date of Electronic Publication: 2024 Jan 22.
DOI: 10.3390/jcm13020619
Abstrakt: Catheter-based revascularization procedures were developed as an alternative to systemic thrombolysis for patients with intermediate-high- and high-risk pulmonary embolisms. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow-up. Secondary endpoints were short- and mid-term changes in the echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate-high-risk PE (86%), were mostly female (57%), and had a mean age of 63.7 ± 14.5 years, and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one, the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036-7.7). RV echocardiographic parameters improved both at 24 h and at follow-up. In-hospital mortality was 3.9% (CI 95%, 1.08-9.74), while all-cause mortality was 11% (CI 95%, 5.4-19.2). Only 12% had bleeding complications, of whom 4.9% were BARC ≥ 3. Preliminary results from the USAT IH-PE registry showed a low incidence of PH, improvement in RV function, and a safe profile.
Databáze: MEDLINE
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