Outcomes post thrombolysis for acute pulmonary embolism

Danish, H.; Dukelow, T.; Plant, Barry J.; Curtin, R.; Henry, M. T.; Kennedy, M. K.; Murphy, Desmond M.

Outcomes post thrombolysis for acute pulmonary embolism

Files

Outcomes-Post-Thrombolysis-for-Acute-Pulmonary-Embolism.pdf(387.59 KB)

Published Version

Date

2020

Authors

Danish, H.

Dukelow, T.

Plant, Barry J.

Curtin, R.

Henry, M. T.

Kennedy, M. K.

Murphy, Desmond M.

Publisher

Irish Medical Organisation

Abstract

Background: Pulmonary embolism (PE) remains a significant cause of mortality in Europe1. Thrombolytic therapy is often utilised as a therapeutic strategy in massive and sub-massive PE. There is a dearth of research on short term complications and subsequent outcomes in patients who have received thrombolysis for PE in Ireland. Methods: This retrospective study examined patients who underwent thrombolysis for acute sub massive PE whilst under the care of the respiratory service in Cork University Hospital (CUH) from 2010-2018. All patients had CTPA done for diagnosis of PE. Alteplase was used as a thrombolytic agent. Patient records were perused. Follow-up pulmonary functions tests (PFTs) and trans-thoracic echocardiogram (TTE) results were assessed for evidence of impairment of diffusing capacity (DLCO) and pulmonary hypertension (PH) respectively. Results: Twenty five patients were included in the study. Nine patients (36%) were women and 64% men. Average age was 55.1 years. Four patients suffered complications related to thrombolysis (average age 63.3 years). Twenty-Two patients (88%) underwent a follow-up echocardiography (mean 30 weeks post PE). Three patients (13%) had echocardiographic evidence of possible mild PH (i.e. RVSP >40mmhg) at initial follow-up. Fourteen patients (56%) who underwent thrombolysis had follow-up PFTs (mean 11.8 months post PE). The diffusing capacity (DLCO) was normal in all patients. Conclusion: Thrombolysis was a relatively safe intervention in this small study.

Keywords

Pulmonary embolism , Thrombolysis

Citation

Danish, H., Dukelow, T., Plant, B. J., Curtin, R., Henry, M. T., Kennedy, M. K. and Murphy, D. M. (2020) 'Outcomes post thrombolysis for acute pulmonary embolism', Irish Medical Journal, 113(6), P103 (4pp). Available at: http://www.imj.ie/wp-content/uploads/2020/06/Outcomes-Post-Thrombolysis-for-Acute-Pulmonary-Embolism.pdf (Accessed: 30 November 2020)