Endovascular Mechanical Thromboembolus Fragmentation in the Treatment of Critical Pulmonary Thromboembolism in Patients with Acute Hemorrhagic Stroke

Homenko, A M; Kusmenko, E A; Пичугин, В. В.; Медведев, А. П.

doi:10.17691/stm2020.12.1.09

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…This increases the risk of widespread bleeding, including intracranial hemorrhage. In contrast, the MT group has a higher proportion of patients who failed or have absolute contraindications to systemic thrombolysis and high surgical risk-i.e., patients who already have an increased risk of bleeding complications [35][36][37].…”

Section: In-hospital Outcomes Of St and Mtmentioning

confidence: 99%

Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective

Srinivasan¹,

Maldonado²,

Melek³

et al. 2022

Cureus

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IntroductionSaddle pulmonary embolism (PE) is a type of central PE that involves the bifurcation of the pulmonary arteries. First-line treatment is usually systemic thrombolytics, but surgical and mechanical thrombectomy (ST and MT) are used for patients with contraindications to thrombolytics or right heart strain. This study compares surgical and mechanical thrombectomy trends and outcomes in patients with saddle PE. MethodsThe data was extracted from the National In-Patient Sample (NIS) from 2016-2018 using the International Classification of Diseases-10-Clinical Modification (ICD-10-CM) diagnosis codes. We used the Cochrane-Armitage trend test to analyze the trends of ST and MT and the chi-square test for statistical analyses. A two-tailed p-value of <0.05 was considered statistically significant. ResultsThe overall trend of MT in saddle PE rose from 2016 to 2018, while ST remained stable. Around 95% of patients undergoing ST/MT were emergent admissions, with 82.5% occurring in teaching hospitals. Patients of age >65 years and more with comorbidity burdens were more likely to undergo MT over ST. In-hospital mortality after ST was 15.1%, and after MT was 11.1% (p:<0.001). The most common complications after ST were congestive heart failure (CHF) and atrial fibrillation (AF), and after MT were vascular events and CHF. ConclusionThe use of mechanical thrombectomy has steadily increased during the study period. ST is more common in large/teaching hospitals, weekend admissions, and patients transferred from other facilities. MT is more common in elderly patients with a higher comorbidity burden. Patients who underwent MT had lower mortality, length of hospital stay, and post-procedural complications.

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Section: In-hospital Outcomes Of St and Mtmentioning

confidence: 99%

Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective

Srinivasan¹,

Maldonado²,

Melek³

et al. 2022

Cureus

View full text Add to dashboard Cite

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Venous thromboembolic complications in patients with intracerebral hemorrhage

Хрипун

Pryamikov

Миронков

et al. 2021

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Clinical and Anamnestic Features and Management of Patients With Pulmonary Embolism in the Kemerovo Region in Comparison With the Results of the “Sirena” Russian Registry

Shmidt,

Berns,

Lozhkina

et al. 2024

Kompleks. probl. serdečno-sosud. zabol.

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HighlightsPatients with pulmonary embolism in the Kemerovo region have severe comorbidities and are older than those included in the Russian registry, however, these patients show a significantly lower rate of thromboembolism provoked by surgical interventions. The management of this group of patients in Kuzbass region includes active recanalization of the pulmonary artery branches with the help of fibrinolysis and surgical methods of thrombus removal. Aim. To comparatively analyze the features of diagnosis, treatment and outcomes in patients with pulmonary embolism (PE) from the Kuzbass patient registry and the results of the “SIRENA” Russian registry.Methods. The registry-based prospective single-center study included 185 patients with PE residing in the Kemerovo region. Moreover, we analyzed the data of 609 patients from the SIRENA registry (observational prospective multicenter study) who underwent a standard examination for patients with PE. Statistical processing of the study results was carried out using the MedCalc Version 16.2.1 software package (Softwa, Belgium).Results. Patients from the Kemerovo region have more adverse risk factors for pulmonary embolism compared with patients from the SIRENA registry: chronic heart failure (CHF) (23.30% versus 50.80%), coronary artery disease (CAD) (8.50%) versus 36.20%), acute stroke) in history (9.90% versus 12.40%), arterial hypertension (AH) (65.70% versus 78.40%), type 2 diabetes mellitus (type 2 diabetes) (15.20% vs. 20.50%), chronic kidney disease (CKD) (9.00% vs. 12.40%).Conclusion. Patients with PE in the Kemerovo region are characterized by a higher prevalence of cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure, venous thromboembolism in the anamnesis), older age, predominance of women, more frequent use of fibrinolysis compared with patients included in the SIRENA Russian registry. Only in Kuzbass specialists used surgical methods of thrombus removal.

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Endovascular Mechanical Thromboembolus Fragmentation in the Treatment of Critical Pulmonary Thromboembolism in Patients with Acute Hemorrhagic Stroke

Cited by 4 publications

References 7 publications

Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective

Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective

Venous thromboembolic complications in patients with intracerebral hemorrhage

Clinical and Anamnestic Features and Management of Patients With Pulmonary Embolism in the Kemerovo Region in Comparison With the Results of the “Sirena” Russian Registry

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