Lungenembolie

Hobohm, Lukas; Lankeit, Mareike

doi:10.1055/a-1029-9937

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Pulmonary embolism (PE) is the third most common cardiovascular cause of death, after myocardial infarction and stroke. The annual incidence is increasing (in Germany from 85/100,000 cases in 2005 to 109/100,000 cases in 2015) [ 1 ]. Computer tomography pulmonary angiography (CTPA) is the gold standard for diagnosing PE.…”

Section: Introductionmentioning

confidence: 99%

Using a Fibrinolysis Delivery Catheter in Pulmonary Embolism Treatment for Measurement of Pulmonary Artery Hemodynamics

Elhakim¹,

Knauth²,

Elhakim

et al. 2022

ARM

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Background: Ultrasound-facilitated and catheter-directed low-dose fibrinolysis (EKOS) has shown favorable hemodynamic and safety outcomes in intermediate- to high-risk pulmonary embolism (PE) cases. Objectives: This prospective single-arm monocentric study assessed the effects of using a delivery catheter for fibrinolysis as a novel approach for acute intermediate- to high-risk patients on pulmonary artery hemodynamics PE. Methods: Forty-five patients (41 intermediate–high and 4 high risk) with computer tomography (CT)-confirmed PE underwent EKOS therapy. By protocol, a total of 6 mg of tissue-plasminogen activator (t-PA) was administered over 6 h in the pulmonary artery (unilateral 6 mg or bilateral 12 mg). Unfractionated heparin was provided periprocedurally. The primary safety outcome was death, as well as major and minor bleeding within 48 of procedure initiation and at 90 days. The primary effectiveness outcomes were: 1. to assess the difference in pulmonary artery pressure from baseline to 6 h post-treatment as a primary precise surrogate marker, and 2. to determine the echocardiographic RV/LV ratio from baseline to 48 h and at 90 days post-delivery. Results: Pulmonary artery pressure decreased by 15/6/10 mmHg (p < 0.001). The mean RV/LV ratio decreased from 1.2 ± 0.85 at baseline to 0.85 ± 0.12 at 48 and to 0.76 ± 0.13 at 90 days (p < 0.001). Five patients (11%) died within 90 days of therapy. Conclusions and Highlights: Pulmonary artery hemodynamics were assessed using a delivery catheter for fibrinolysis, which is reproducible for identifying PE at risk of adverse outcomes. The results matched the right heart catheter results in EKOS and Heparin arm of Ultima trial, thereby confirming the validity of this potential diagnostic tool to assess therapy effectiveness and thereby reduce additional procedure-related complications, hospital residency, and economics. These results stress the importance of having an interdisciplinary team involved in the management of PE to evaluate the quality of life of these patients and this protocol shortens ICU admission to 6 h.

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Section: Introductionmentioning

confidence: 99%

Using a Fibrinolysis Delivery Catheter in Pulmonary Embolism Treatment for Measurement of Pulmonary Artery Hemodynamics

Elhakim¹,

Knauth²,

Elhakim

et al. 2022

ARM

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Research on the Mechanics of Thrombosis Interface Damage Evolution

Zhou,

Chen,

et al. 2024

Preprint

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The shedding of thrombosis can pose diagnostic difficulties for clinicians as it results in risks of damage. Determining the appropriate treatment, drug thrombolysis, implanted vascular stents, clinical research, or surgical cutting is often challenging. To better understand the interfacial mechanical mechanism of thrombus shedding, a fluid-solid coupling finite element model was created based on viscoelasticity-based blood vessels, line elastic thrombosis, and Euler fluid blood to establish a connective interface between blood vessels and thrombosis. Under hypertension conditions, the interface mechanics model calculated the finite element interface performance of thrombosis with different degrees of calcification, thicknesses, and coverage angles, using the mechanical parameters to assess damage for the interface of different structural thromboses. The study analyzed and clarified the evolution mechanism of damage and exfoliation of the thrombotic interface in blood vessels under various conditions. The results revealed that the mechanics of damage and the shedding mechanism of the thrombosis were significantly affected by the different coverage angles. Based on these analyses, this study determined that the finite element method based on the Coupled Eulerian–Lagrangian method, including the interface model of the cohesive zone volume element layer, could well simulate the mechanics of damage and the shedding mechanism of the thrombotic interface under the impact of hypertension. This study is the first to explore the finite element interface damage model of thrombosis and the vessel wall using interfacial mechanics.

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Lungenembolie

Cited by 2 publications

References 40 publications

Using a Fibrinolysis Delivery Catheter in Pulmonary Embolism Treatment for Measurement of Pulmonary Artery Hemodynamics

Using a Fibrinolysis Delivery Catheter in Pulmonary Embolism Treatment for Measurement of Pulmonary Artery Hemodynamics

Research on the Mechanics of Thrombosis Interface Damage Evolution

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