Ali Azari1, Ahmad Tashakori Beheshti2, Zahra Moravvej3, Leila Bigdelu4, Maryam Salehi5. 1. Department of Cardiac Surgery, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 3. Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Member of Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Cardiology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: Bigdelul@mums.ac.ir. 5. Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
OBJECTIVE: Comparison between surgical embolectomy and thrombolytic therapy in patients suffering from acute massive pulmonary embolism (AMPE). BACKGROUND: Prompt treatment of AMPE is necessary, although optimal management is a matter of debate. METHODS: Patients with AMPE were assigned to either thrombolytic therapy or pulmonary surgical embolectomy. Early and late mortality, systolic pulmonary artery pressure (SPAP), right ventricular diameter (RVD) and bleeding complications were evaluated. RESULTS: Seventy eight patients were treated with thrombolytic therapy and 30 patients underwent surgery. The difference between pre-intervention and third-day post-intervention in terms of RVD and SPAP was significantly greater in patients under surgical embolectomy (P < 0.001). There was a significant decline in RVD and SPAP in both groups during follow-up (P < 0.001). Mortality rate in the surgical embolectomy group was lower than the thrombolytic group although not significantly. CONCLUSION: Early surgical treatment was associated with fewer complications in comparison to thrombolytic therapy.
OBJECTIVE: Comparison between surgical embolectomy and thrombolytic therapy in patients suffering from acute massive pulmonary embolism (AMPE). BACKGROUND: Prompt treatment of AMPE is necessary, although optimal management is a matter of debate. METHODS:Patients with AMPE were assigned to either thrombolytic therapy or pulmonary surgical embolectomy. Early and late mortality, systolic pulmonary artery pressure (SPAP), right ventricular diameter (RVD) and bleeding complications were evaluated. RESULTS: Seventy eight patients were treated with thrombolytic therapy and 30 patients underwent surgery. The difference between pre-intervention and third-day post-intervention in terms of RVD and SPAP was significantly greater in patients under surgical embolectomy (P < 0.001). There was a significant decline in RVD and SPAP in both groups during follow-up (P < 0.001). Mortality rate in the surgical embolectomy group was lower than the thrombolytic group although not significantly. CONCLUSION: Early surgical treatment was associated with fewer complications in comparison to thrombolytic therapy.
Authors: Belinda Rivera-Lebron; Michael McDaniel; Kamran Ahrar; Abdulah Alrifai; David M Dudzinski; Christina Fanola; Danielle Blais; David Janicke; Roman Melamed; Kerry Mohrien; Elizabeth Rozycki; Charles B Ross; Andrew J Klein; Parth Rali; Nicholas R Teman; Leoara Yarboro; Eugene Ichinose; Aditya M Sharma; Jason A Bartos; Mahir Elder; Brent Keeling; Harold Palevsky; Soophia Naydenov; Parijat Sen; Nancy Amoroso; Josanna M Rodriguez-Lopez; George A Davis; Rachel Rosovsky; Kenneth Rosenfield; Christopher Kabrhel; James Horowitz; Jay S Giri; Victor Tapson; Richard Channick Journal: Clin Appl Thromb Hemost Date: 2019 Jan-Dec Impact factor: 2.389