Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results

Colombo, C.; Capsoni, N.; Russo, F.; Iannaccone, M.; Adamo, M.; Viola, G.; Bossi, I.E.; Villanova, L.; Tognola, C.; Curci, C.; Morelli, F.; Guerrieri, R.; Occhi, L.; Chizzola, G.; Rampoldi, A.; Musca, F.; De Nittis, G.; Galli, M.; Boccuzzi, G.; Savio, D.; Bernasconi, D.; D’Angelo, L.; Garascia, A.; Chieffo, A.; Montorfano, M.; Oliva, F.; Sacco, A. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results. J. Clin. Med. 2024, 13, 619. Colombo, C.; Capsoni, N.; Russo, F.; Iannaccone, M.; Adamo, M.; Viola, G.; Bossi, I.E.; Villanova, L.; Tognola, C.; Curci, C.; Morelli, F.; Guerrieri, R.; Occhi, L.; Chizzola, G.; Rampoldi, A.; Musca, F.; De Nittis, G.; Galli, M.; Boccuzzi, G.; Savio, D.; Bernasconi, D.; D’Angelo, L.; Garascia, A.; Chieffo, A.; Montorfano, M.; Oliva, F.; Sacco, A. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results. J. Clin. Med. 2024, 13, 619.

Abstract

Catheter-based revascularization procedures developed as an alternative of systemic thrombolysis for patients at intermediate-high and high-risk pulmonary embolism. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow up. Secondary endpoints were short- and mid-term changes in echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate-high risk PE (86%), mostly female (57%), median age 66.5 years (IQR 56-74), and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036-7.7). RV echocardiographic parameters improved both at 24 hours and at follow up. In-hospital mortality was 3.9% (CI 95%, 1.08-9.74) while all-cause mortality was 11% (CI 95%, 5.4-19.2). Only 12% had bleeding complications, oh whom 4.9% were BARC 3. Preliminary results from USAT IH-PE registry showed low incidence of PH, improvement in RV function and a safe profile.

Keywords

pulmonary embolism; ultrasound assisted; catheter-directed thrombolysis; pulmonary hypertension

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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