2022-11-212022-11-212016-10Sağ, S. vd. (2016). "Catheter-directed ultrasound-accelerated thrombolysis may be life-saving in patients with massive pulmonary embolism after failed systemic thrombolysis". Journal of Thrombosis and Thrombolysis, 42(3), 322-328.0929-53051573-742Xhttps://doi.org/10.1007/s11239-016-1370-3https://link.springer.com/article/10.1007/s11239-016-1370-3http://hdl.handle.net/11452/29512The treatment options for high risk acute pulmonary embolism (PE) patients with failed systemic thrombolytic treatment (STT) is limited. The clinical use of catheter directed thrombolysis with the EkoSonic Endovascular System (EKOS) in this population has not been evaluated before. Catheter directed thrombolysis is an effective treatment modality for high risk PE patients with failed STT. Thirteen consecutive patients with failed STT were included in the study. EKOS catheters were placed and tissue plasminogen activator (t-PA) in combination with unfractionated heparin were given. Clinical and echocardiographic properties of the patients were collected before EKOS, at the end of EKOS and during the follow-up visit 6 months after discharge. The duration of EKOS treatment was 21.8 +/- 3.8 h and the total dose of tPA was 31.2 +/- 15.3 mg. One patient who presented with cardiac arrest died and the clinical status of the remaining subjects improved significantly. Any hemorrhagic complication was not observed. EKOS resulted in significant improvement of right ventricular functions and decrease of systolic pulmonary artery pressure. During a follow-up period of 6 months none of the patients died or suffered recurrent PE. In addition, echocardiographic parameters or right ventricular function significantly got better compared to in-hospital measurements. EKOS is an effective treatment modality for high risk PE patients with failed STT and can be applied with very low hemorrhagic complications.eninfo:eu-repo/semantics/closedAccessCardiovascular system & cardiologyHematologyAcute pulmonary embolismFailed systemic thrombolytic treatmentCatheter directed thrombolysisEkoSonic endovascular systemEuropean-societyIntermediateEmbolectomyTherapyFragmentationFibrinolysisGuidelinesManagementCardiologySafetyCathetersFemaleHeparinHumansMaleMechanical thrombolysisMiddle agedPulmonary embolismSalvage therapyThrombolytic therapyTissue plasminogen activatorTreatment outcomeUltrasonic surgical proceduresArticle0003828687000022-s2.0-8496461421632232842327129723Cardiac & cardiovascular systemsHematologyPeripheral vascular diseaseLung Embolism; Embolectomy; Blood Clot LysisHeparinTissue plasminogen activatorAbsence of complicationsAcute pulmonary embolismAdultArticleCatheter directed thrombolysisCause of deathClinical articleClinical assessmentControlled clinical trialControlled studyEchocardiographyFemaleFlush catheterFollow upHeart arrestHeart right ventricle functionHigh risk patientHospital dischargeHumanLung artery pressureLung embolismMaleMechanical thrombectomyPriority journalProspective studySystemic thrombolytic treatmentTreatment durationTreatment failureCatheterDevicesEvaluation studyFibrinolytic therapyMechanical thrombectomyMiddle agedProceduresPulmonary embolismSalvage therapyTreatment outcomeUltrasound surgery