Feasibility of ultrasound-assisted catheter-directed thrombolysis for submassive pulmonary embolism: A meta-analysis of case series

Clin Respir J. 2020 May;14(5):430-439. doi: 10.1111/crj.13155. Epub 2020 Feb 4.

Abstract

Background: During the past few years, there has been a surge in the use of ultrasound-assisted catheter-directed thrombolysis (UACDT) for submassive pulmonary embolism (SPE). However, few studies evaluated the feasibility of UACDT for SPE.

Purpose: To evaluate the feasibility of UACDT in treating SPE.

Methods: A comprehensive search of online databases was performed. Search terms UACDT in SPE were entered into PubMed, Embase, Scopus and the Cochrane Library to identify related articles published until October 2018. A quality assessment and data extraction were performed by two researchers. Meta-analysis was performed using R statistical software.

Results: Twelve studies with 485 patients were included in this meta-analysis. The pooled right ventricular/left ventricular ratio decrease and pulmonary artery systolic pressure drop after treatment was -0.34 (95% CI: -0.43, -0.25) and -15.05 (95% CI: -18.10, -12.00) mm Hg, respectively. The pooled major bleeding rate was 1.0% (95% CI: 0.0%, 3.0%), and the in-hospital mortality was 0.0% (95% CI: 0.0%, 1.0%).

Conclusion: This up to data meta-analysis confirms that UACDT is a feasible treatment for SPE.

Keywords: case series; feasibility; meta-analysis; submassive pulmonary embolism; ultrasound-assisted catheter-directed thrombolysis.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheters
  • Evaluation Studies as Topic
  • Feasibility Studies
  • Female
  • Hemorrhage / epidemiology
  • Hemorrhage / etiology*
  • Hospital Mortality / trends
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Embolism / therapy*
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / instrumentation*
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*