Catheter-Directed Treatment of Pulmonary Embolism

A Systematic Review and Meta-Analysis of Modern Literature

Alfonso J. Tafur, Fadi E. Shamoun, Salma I. Patel, Denisse Tafur, Fabiola Donna, Mohammad H Murad

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

We summarize the evidence for the safety and efficacy of catheter-directed thrombolysis (CDT) with and without ultrasound-assisted therapy for treating submassive and massive pulmonary embolism (PE) in a systematic review. The primary efficacy outcome was mortality. Outcomes were pooled across studies with the random-effects model. Twenty-four studies enrolled 700 patients in total; 653 received mechanical thromboembolectomy treatments for PE (mortality rate, 9% [95% confidence interval (CI), 6%-13%], P =.12; rate of minor complications, 6% [95% CI, 2%-13%]). In the ultrasound-accelerated thrombolysis (USAT) studies, the mortality rate was 4% (95% CI, 1%-11%) and in the non-USAT studies, it was 9% (95% CI, 6%-13%). Secondary safety outcomes were all bleeding events, which occurred in 12% (95% CI, 7%-20%) of the USAT studies and in 10% (95% CI, 5%-20%) of the non-USAT studies. Current clinical evidence does not prove USAT is superior over CDT methods.

Original languageEnglish (US)
Pages (from-to)821-829
Number of pages9
JournalClinical and Applied Thrombosis/Hemostasis
Volume23
Issue number7
DOIs
StatePublished - Oct 1 2017

Fingerprint

Modern Literature
Pulmonary Embolism
Meta-Analysis
Catheters
Confidence Intervals
Mortality
Therapeutics
Safety
Hemorrhage

Keywords

  • catheter-directed thrombolysis
  • pulmonary embolism
  • thrombolysis

ASJC Scopus subject areas

  • Hematology

Cite this

Catheter-Directed Treatment of Pulmonary Embolism : A Systematic Review and Meta-Analysis of Modern Literature. / Tafur, Alfonso J.; Shamoun, Fadi E.; Patel, Salma I.; Tafur, Denisse; Donna, Fabiola; Murad, Mohammad H.

In: Clinical and Applied Thrombosis/Hemostasis, Vol. 23, No. 7, 01.10.2017, p. 821-829.

Research output: Contribution to journalReview article

Tafur, Alfonso J. ; Shamoun, Fadi E. ; Patel, Salma I. ; Tafur, Denisse ; Donna, Fabiola ; Murad, Mohammad H. / Catheter-Directed Treatment of Pulmonary Embolism : A Systematic Review and Meta-Analysis of Modern Literature. In: Clinical and Applied Thrombosis/Hemostasis. 2017 ; Vol. 23, No. 7. pp. 821-829.
@article{1ffcdead13284ba2a569b6577e794120,
title = "Catheter-Directed Treatment of Pulmonary Embolism: A Systematic Review and Meta-Analysis of Modern Literature",
abstract = "We summarize the evidence for the safety and efficacy of catheter-directed thrombolysis (CDT) with and without ultrasound-assisted therapy for treating submassive and massive pulmonary embolism (PE) in a systematic review. The primary efficacy outcome was mortality. Outcomes were pooled across studies with the random-effects model. Twenty-four studies enrolled 700 patients in total; 653 received mechanical thromboembolectomy treatments for PE (mortality rate, 9{\%} [95{\%} confidence interval (CI), 6{\%}-13{\%}], P =.12; rate of minor complications, 6{\%} [95{\%} CI, 2{\%}-13{\%}]). In the ultrasound-accelerated thrombolysis (USAT) studies, the mortality rate was 4{\%} (95{\%} CI, 1{\%}-11{\%}) and in the non-USAT studies, it was 9{\%} (95{\%} CI, 6{\%}-13{\%}). Secondary safety outcomes were all bleeding events, which occurred in 12{\%} (95{\%} CI, 7{\%}-20{\%}) of the USAT studies and in 10{\%} (95{\%} CI, 5{\%}-20{\%}) of the non-USAT studies. Current clinical evidence does not prove USAT is superior over CDT methods.",
keywords = "catheter-directed thrombolysis, pulmonary embolism, thrombolysis",
author = "Tafur, {Alfonso J.} and Shamoun, {Fadi E.} and Patel, {Salma I.} and Denisse Tafur and Fabiola Donna and Murad, {Mohammad H}",
year = "2017",
month = "10",
day = "1",
doi = "10.1177/1076029616661414",
language = "English (US)",
volume = "23",
pages = "821--829",
journal = "Clinical and Applied Thrombosis/Hemostasis",
issn = "1076-0296",
publisher = "SAGE Publications Inc.",
number = "7",

}

TY - JOUR

T1 - Catheter-Directed Treatment of Pulmonary Embolism

T2 - A Systematic Review and Meta-Analysis of Modern Literature

AU - Tafur, Alfonso J.

AU - Shamoun, Fadi E.

AU - Patel, Salma I.

AU - Tafur, Denisse

AU - Donna, Fabiola

AU - Murad, Mohammad H

PY - 2017/10/1

Y1 - 2017/10/1

N2 - We summarize the evidence for the safety and efficacy of catheter-directed thrombolysis (CDT) with and without ultrasound-assisted therapy for treating submassive and massive pulmonary embolism (PE) in a systematic review. The primary efficacy outcome was mortality. Outcomes were pooled across studies with the random-effects model. Twenty-four studies enrolled 700 patients in total; 653 received mechanical thromboembolectomy treatments for PE (mortality rate, 9% [95% confidence interval (CI), 6%-13%], P =.12; rate of minor complications, 6% [95% CI, 2%-13%]). In the ultrasound-accelerated thrombolysis (USAT) studies, the mortality rate was 4% (95% CI, 1%-11%) and in the non-USAT studies, it was 9% (95% CI, 6%-13%). Secondary safety outcomes were all bleeding events, which occurred in 12% (95% CI, 7%-20%) of the USAT studies and in 10% (95% CI, 5%-20%) of the non-USAT studies. Current clinical evidence does not prove USAT is superior over CDT methods.

AB - We summarize the evidence for the safety and efficacy of catheter-directed thrombolysis (CDT) with and without ultrasound-assisted therapy for treating submassive and massive pulmonary embolism (PE) in a systematic review. The primary efficacy outcome was mortality. Outcomes were pooled across studies with the random-effects model. Twenty-four studies enrolled 700 patients in total; 653 received mechanical thromboembolectomy treatments for PE (mortality rate, 9% [95% confidence interval (CI), 6%-13%], P =.12; rate of minor complications, 6% [95% CI, 2%-13%]). In the ultrasound-accelerated thrombolysis (USAT) studies, the mortality rate was 4% (95% CI, 1%-11%) and in the non-USAT studies, it was 9% (95% CI, 6%-13%). Secondary safety outcomes were all bleeding events, which occurred in 12% (95% CI, 7%-20%) of the USAT studies and in 10% (95% CI, 5%-20%) of the non-USAT studies. Current clinical evidence does not prove USAT is superior over CDT methods.

KW - catheter-directed thrombolysis

KW - pulmonary embolism

KW - thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=85029749570&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029749570&partnerID=8YFLogxK

U2 - 10.1177/1076029616661414

DO - 10.1177/1076029616661414

M3 - Review article

VL - 23

SP - 821

EP - 829

JO - Clinical and Applied Thrombosis/Hemostasis

JF - Clinical and Applied Thrombosis/Hemostasis

SN - 1076-0296

IS - 7

ER -