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Comparison between systemic and catheter thrombolysis in patients with pulmonary embolism

  • Author Footnotes
    1 Both authors contributed equally to this work.
    Jung-Wan Yoo
    Footnotes
    1 Both authors contributed equally to this work.
    Affiliations
    Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea
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  • Author Footnotes
    1 Both authors contributed equally to this work.
    Ho Cheol Choi
    Footnotes
    1 Both authors contributed equally to this work.
    Affiliations
    Department of Radiology, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
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  • Seung Jun Lee
    Affiliations
    Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea
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  • Yu Ji Cho
    Affiliations
    Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea
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  • Jong Deog Lee
    Affiliations
    Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea
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  • Ho Cheol Kim
    Correspondence
    Corresponding author: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 90, Chilam-Dong, Jinju, Gyeongnam-do 660-302, Republic of Korea. Tel.: +82 55 750 8684; fax: +82 55 750 8618.
    Affiliations
    Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do, Republic of Korea
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  • Author Footnotes
    1 Both authors contributed equally to this work.
Published:February 15, 2016DOI:https://doi.org/10.1016/j.ajem.2016.02.037

      Abstract

      Background

      Although systemic thrombolysis (ST) or catheter-directed therapy (CDT) is performed in patients with acute massive or submassive pulmonary embolism (PE), clinical data comparing between both therapies remain limited. We compared clinical outcomes between ST and CDT in patients with acute massive and submassive PE.

      Methods

      From January 2005 to June 2015, clinical outcomes of patients with acute massive or submassive PE receiving ST or CDT were evaluated and compared retrospectively.

      Results

      Of 72 patients, 44 were treated with ST; and 28, with CDT. The mean age was 63.9 ± 17 years old. The proportion of male sex was higher in patients receiving CDT compared to that with ST (46.4% vs 20.5%; P = .02). Half of patients presented with massive PE, and cardiac arrest occurred in 11 patients (15.3%). No difference was observed between the 2 groups with respect to 7-day mortality (13.6% in ST vs 10.7% in CDT), inhospital mortality (13.6% in ST vs 14.3% in CDT), and major bleeding complication (16.7% in ST vs 16.7% in CDT). Cardiac arrest (odds ratio, 6.286; 95% confidence interval, 1.081-36.555; P = .041) was associated with 14-day mortality.

      Conclusions

      Similar clinical outcomes were shown between ST and CDT in patients with acute massive or submassive PE.
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