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

16 Scopus citations

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

Keywords

  • catheter-directed thrombolysis
  • pulmonary embolism
  • thrombolysis

ASJC Scopus subject areas

  • Hematology

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