intravenous catheter-directed thrombolysis
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Indications
- intermediate & high-risk pulmonary embolism*[2]
- perhaps not deep vein thrombosis[1]
* lower mortality vs systemic thrombolysis (RR=0.43 vs systemic thrombolysis) & (RR=0.36 vs anticoagulation)[2]
Procedure
- intravenous catheter of pulmonary artery catheter directed thrombolysis
- uses < 1/4 dose of thrombolytic agent vs systemic thrombolysis
Complications
- pulmonary embolism (18% vs 11%) for anticoagulation alone
- intracranial hemorrhage (0.9% vs 0.3%)
- major bleeding & intracranial hemorrhage less than systemic thrombolysis & similar to anticoagulation[2]
- need for vena cava filter placement (35% vs 16%)
- longer & more expensive hospital stays[1]
More general terms
Additional terms
References
- ↑ Jump up to: 1.0 1.1 1.2 Bashir R et al Comparative Outcomes of Catheter-Directed Thrombolysis Plus Anticoagulation vs Anticoagulation Alone to Treat Lower- Extremity Proximal Deep Vein Thrombosis. JAMA Intern Med. Published online July 21, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25047081 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1889011
- ↑ Jump up to: 2.0 2.1 2.2 2.3 Planer D et al. Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: Systematic review and network meta-analysis. CMAJ 2023 Jun 19; 195:E833. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37336568 PMCID: PMC10281204 Free PMC article https://www.cmaj.ca/content/195/24/E833