Surgical Treatment of a Massive Pulmonary Embolism After a Double Cardiac Arrest

Reyes, Guillermo; Tamura, Akiko; Guerrero, José L.; Hernando, Luis M.

doi:10.1016/s1885-5857(08)60037-7

Cited by 2 publications

(6 citation statements)

References 15 publications

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“…Several investigators have shown no survival advantage of thrombolytic therapy over SPE. 2,4,5,15,16) Significant hemorrhagic complications occur in nearly 25% of thrombolysis patients compared to 15% in SPE. 5,15,31) Recurrent PE is a known complication of all treatment modalities, but tend to occur more frequently following thrombolysis (21%) than SPE (7.7%).…”

Section: Discussionmentioning

confidence: 99%

“…2,4,5,15,16) Significant hemorrhagic complications occur in nearly 25% of thrombolysis patients compared to 15% in SPE. 5,15,31) Recurrent PE is a known complication of all treatment modalities, but tend to occur more frequently following thrombolysis (21%) than SPE (7.7%). 5,15,16) Regardless of treatment strategy, IVC filter placement should be performed either during the index procedure or shortly thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…8) Postoperative anticoagulation is a necessary component of postoperative management and serves to prevent recurrent PE. 5) Studies indicate that with appropriate postoperative anticoagulation, the risk of recurrent PE is less than 5%. 5) While low molecular weight heparin bridged to warfarin was once the treatment of choice, direct oral anticoagulants (DOACs) are now recommended as the first-line therapy for most patients.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…5) Studies indicate that with appropriate postoperative anticoagulation, the risk of recurrent PE is less than 5%. 5) While low molecular weight heparin bridged to warfarin was once the treatment of choice, direct oral anticoagulants (DOACs) are now recommended as the first-line therapy for most patients. 7,32) DOACs including dabigatran, apixaban, rivaroxaban, and edoxaban have been shown to be non-inferior to warfarin in a series of large meta-analyses including the RE-COVER, RE-COVER II, EINSTEIN-DVT, EIN-STEIN-PE, AMPLIFY, and Hokusai-VTE trials.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…2,3) Early diagnosis and intervention are paramount as most deaths from acute PE occur within the first several hours to days, with over 70% of deaths occurring within the first hour. 4,5) The most common risk factor for PE is a history of prior deep vein thrombosis (DVT). 2) However, Ann Thorac Cardiovasc Surg 2020; 26: 65-71 Online October 5, 2019 doi: 10.5761/atcs.ra.…”

Section: Introductionmentioning

confidence: 99%

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Current Management of Acute Pulmonary Embolism

Licha

McCurdy

Maldonado

et al. 2020

ATCS

103

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Purpose: Acute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. While non-surgical approaches have supplanted surgery as primary treatment, surgical pulmonary embolectomy (SPE) remains a vital option for select patients. We review the current management of acute PE, with a focus on surgical therapy. Methods: A PubMed search was performed to identify literature regarding PE and treatment. Results were filtered to include the most comprehensive publications over the past decade. Results: PE is stratified based on presenting hemodynamic status or degree of mechanical pulmonary arterial occlusion. Although systemic or catheter-guided fibrinolysis is the preferred first-line treatment for the majority of cases, patients who are not candidates should be considered for SPE. Studies demonstrate no mortality benefit of thrombolysis over surgery. Systemic anticoagulation is a mainstay of treatment regardless of intervention approach. Following surgical embolectomy, direct oral anticoagulants (DOACs) have been shown to reduce recurrence of thromboembolism. Conclusions: Acute PE presents with varying degrees of clinical stability. Patients should be evaluated in the context of various available treatment options including medical, catheter-based, and surgical interventions. SPE is a safe and appropriate treatment option for appropriate patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Postoperative Managementmentioning

confidence: 99%

Section: Postoperative Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current Management of Acute Pulmonary Embolism

Licha

McCurdy

Maldonado

et al. 2020

ATCS

103

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Sirtuin3 confers protection against acute pulmonary embolism through anti-inflammation, and anti-oxidative stress, and anti-apoptosis properties: participation of the AMP-activated protein kinase/mammalian target of rapamycin pathway

Han

Jia

et al. 2023

Exp. Anim.

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Increasing studies have suggested that oxidative stress and inflammation play momentous roles in acute pulmonary embolism (APE). Honokiol, a bioactive biphenolic phytochemical substance, is known for its strong anti-oxidative and antiinflammatory effects and here serves as an activator of sirtuin3 (SIRT3). The purposes of the study are to explore the effects of Honokiol on APE rats, and investigate whether the function of Honokiol is mediated by SIRT3 activation. In this study, the rats received a right femoral vein injection with dextran gel G-50 particles (12 mg/kg) to establish the APE model, which were administrated with Honokiol and/or selective SIRT3 inhibitor 3-(1H-1, 2, 3-triazol-4-yl) pyridine (3-TYP; 5 mg/kg) intraperitoneally. The data showed that SIRT3 activation by Honokiol attenuated the loss in lung function, ameliorated inflammatory response and oxidative damage as well as inhibited apoptosis in lung tissues of the rats with APE, which was reversed by 3-TYP. In addition, we found AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway might be activated by Honokiol but restrained by 3-TYP. These results indicated that Honokiol was capable of suppressing APE's adverse effects, which was diminished by SIRT3 suppression, implying that activation of SIRT3 might serve as a therapeutic method for APE.

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Surgical Treatment of a Massive Pulmonary Embolism After a Double Cardiac Arrest

Cited by 2 publications

References 15 publications

Current Management of Acute Pulmonary Embolism

Current Management of Acute Pulmonary Embolism

Sirtuin3 confers protection against acute pulmonary embolism through anti-inflammation, and anti-oxidative stress, and anti-apoptosis properties: participation of the AMP-activated protein kinase/mammalian target of rapamycin pathway

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