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- W1996575237 abstract "Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate due to acute right ventricular failure and cardiogenic shock. As soon as the diagnosis is suspected, an IV bolus of unfractionated heparin should be administered. In addition to anticoagulation, rapid initiation of systemic thrombolysis is potentially life-saving and therefore is standard therapy. Many patients with massive PE cannot receive thrombolysis because of an increased bleeding risk, such as prior surgery, trauma, or cancer. In these patients, catheter or surgical embolectomy are helpful for rapidly reversing right ventricular failure. Catheter thrombectomy appears to be particularly useful if surgical embolectomy is not available or the patient has contraindications to surgery. Although no controlled clinical trials are available, data from cohort studies indicate that the clinical outcomes after surgical and catheter embolectomy may be comparable. Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate due to acute right ventricular failure and cardiogenic shock. As soon as the diagnosis is suspected, an IV bolus of unfractionated heparin should be administered. In addition to anticoagulation, rapid initiation of systemic thrombolysis is potentially life-saving and therefore is standard therapy. Many patients with massive PE cannot receive thrombolysis because of an increased bleeding risk, such as prior surgery, trauma, or cancer. In these patients, catheter or surgical embolectomy are helpful for rapidly reversing right ventricular failure. Catheter thrombectomy appears to be particularly useful if surgical embolectomy is not available or the patient has contraindications to surgery. Although no controlled clinical trials are available, data from cohort studies indicate that the clinical outcomes after surgical and catheter embolectomy may be comparable. Percutaneous Mechanical Thrombectomy for Acute Pulmonary Embolism: A Double-Edged SwordCHESTVol. 132Issue 2PreviewMajor pulmonary embolism (PE) can cause death from right-heart failure1 and, among survivors, may lead to disabling chronic thromboembolic PE.2 Massive PE is rare but often obvious when it occurs during hospitalization. There is dramatic sudden onset of hypotension, tachycardia, and respiratory distress, often accompanied by new right bundle-branch block on the ECG. This medical emergency can be catastrophic and usually requires emergency thrombolysis or embolectomy in addition to intensive anticoagulation, vasopressors, and mechanical ventilation. Full-Text PDF Paradoxical Worsening of Shock After the Use of a Percutaneous Mechanical Thrombectomy Device in a Postpartum Patient With a Massive Pulmonary EmbolismCHESTVol. 132Issue 2PreviewMajor pulmonary embolism (PE), defined as PE presenting with shock, has a mortality rate of nearly 60%.1 Effective therapy for PE leading to obstructive shock must reduce pulmonary arterial clot burden in order to decrease right ventricular afterload and reverse right ventricular failure. While different strategies to reduce or remove thrombus have not been compared to each other, or to control, in clinical trials, both systemic thrombolysis and surgical thrombectomy have been used successfully in this setting. Full-Text PDF" @default.
- W1996575237 created "2016-06-24" @default.
- W1996575237 creator A5071945009 @default.
- W1996575237 date "2007-08-01" @default.
- W1996575237 modified "2023-10-18" @default.
- W1996575237 title "Catheter Embolectomy for Acute Pulmonary Embolism" @default.
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- W1996575237 doi "https://doi.org/10.1378/chest.07-0665" @default.
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