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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

HAMEAU, René et al. Use of Local Thrombolysis associated to Therapeutic ultrasound (EKOSonic) in patients with Acute Pulmonary Thromboembolism: a preliminary experience. Rev Chil Cardiol [online]. 2020, vol.39, n.2, pp.133-146. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602020000200133.

Background:

Pulmonary thromboembolism (PE) is a common cause of cardiovascular morbidity and mortality and local ultrasound-assisted thrombolysis (USAT) is a validated alternative treatment for intermediate-risk patients. There are no reports on the use of this technology in our country.

Methods:

Prospective series of patients with acute, intermediate-risk PE treated percutaneously with therapeutic ultrasound catheter-assisted local thrombolysis (EKOSonic®). The efficacy and safety of the procedure were analyzed using clinical, hemodynamic, and radiological variables, as well as intra-hospital outcomes. The 30-day follow-up is also reported.

Results:

between June 2019 and March 2020, a total of 4 patients with intermediate-risk PE were treated with this technique. The average PESI score was 79.5 + 6.1. Two out of 4 patients required the use of 2 catheters for bilateral therapy. The average reduction in systolic pressure of the pulmonary artery was 29% and 3 patients reversed the right ventricular dilation present at admission. The thrombotic burden was reduced by 20% according to the Computed Tomography Obstruction Index (CTOI). There were no intraoperative or in hospital complications associated with the intervention.

Conclusion:

In this initial series, the use of local thrombolysis with an ultrasound catheter in patients with intermediate-risk PE was safe and effective. The perioperative and 30-day outcomes were similar to those previously reported in international series. However, larger randomized trials are needed to confirm this potential benefit.

Keywords : Pulmonary thromboembolism; thrombolisis; EKOsonic technique.

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