Ultrasound Accelerated Catheter Directed Thrombolysis for Pulmonary Embolus and Right Heart Thrombus Secondary to Transvenous Pacing Wires

Amankwah, Kwame S.; Seymour, Keri A.; Costanza, Michael J.; Gahtan, Vivian

doi:10.1177/1538574410395040

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…Only a few cases were reported to solve the problem by catheter-directed thrombolysis but with good results [8][9][10][11]. Here we report another even more complicated case with PICC-related thrombi in both right atrium and upper extremity.…”

Section: Introductionmentioning

confidence: 79%

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Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters

Guo¹,

Li²

2019

Int J Case Rep Images

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Introduction: Peripherally inserted central catheters (PICC) are widely applied in clinical practice. One of the foremost complications is the potential risk for thrombosis associated with their use. Especially the thrombi within the cardiac chambers are rarely observed in clinical practice, but they are potentially deadly to patients for pulmonary embolism. There are no evidencebased guidelines for their treatment, and the optimal treatment is controversial (conservative or positive). Case Report: We report the case of a 52-year-old female, who presented with both a right atrial thrombus and upper extremity deep vein thrombi on three days following PICC insertion. After an elaborate surgery with two catheters for thrombolysis and one filter for prevention of pulmonary embolism, the thrombi were dissolved effectively without occurrence of any complications. Conclusion: In summary, regarding the treatment choice of complex thrombi in both right atrium and upper extremity, with the development of vascular surgery and interventional equipment, interventional treatment might be a well-tolerated therapeutic option. The ingenious surgical design of two catheters for thrombolysis and one filter for prevention of pulmonary embolism highlights a safe and feasible treatment for this kind of thrombi with minimal trauma.

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Section: Introductionmentioning

confidence: 79%

“…Catheter-directed thrombolysis (CDT). According to previous literature, only a few cases of right atrial thrombus have been treated by interventional surgery [8][9][10][11]. There were no clear guidelines for this kind of treatment.…”

Section: Discussionmentioning

confidence: 99%

Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters

Guo¹,

Li²

2019

Int J Case Rep Images

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“…Human studies report it in up to 45% of cases [ 11 , 12 , 16 , 21 ], and the recently published multicenter study on dogs reported an incidence of 10% in 260 dogs [ 10 ]. In case the pacemaker-lead-associated thrombosis leads to clinical signs, typically due to congestion, treatment can be warranted [ 21 , 22 , 23 ]. Both anticoagulant and interventional therapies have been reported in dogs [ 8 , 9 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Thromboembolism and Myocarditis Resulting from a Large Pacing-Lead-Associated Right Ventricular Thrombus in a Dog with Chronic Cough as Presenting Sign

Szatmári,

Thomas

2024

Veterinary Sciences

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In the present case report, we describe the clinical course and postmortem findings of a 12-year-old Labrador retriever dog with a third-degree atrio-ventricular block that developed a chronic cough, and later dyspnea and weakness as a result of massive pulmonary thromboembolism 3 years after implantation of a transvenous permanent pacemaker. A large soft tissue mass was seen in the right ventricular chamber around the pacing lead with echocardiography. Initially, this was thought to be caused by mural bacterial endocarditis based on hyperthermia, severe leukocytosis and the appearance of runs of ventricular tachycardia, the latter suggesting myocardial damage. While blood culture results were pending, antibiotics were administered without a positive effect. Due to clinical deterioration, the owner elected for euthanasia and a post-mortem examination confirmed a right ventricular thrombus and surrounding myocarditis, without signs of bacterial infection, and a massive pulmonary thromboembolism. We conclude that pulmonary thromboembolism should be considered in dogs with a cough that have an endocardial pacing lead implanted. Serial screening for proteinuria before and after implantation of an endocardial pacing lead would allow timely initiation of prophylactic antiplatelet therapy. Local myocarditis can develop secondary to an intracavitary thrombus, which can subsequently lead to runs of ventricular tachycardia.

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“…There is currently no consensus on treatment of PLAT in people or in dogs. Therapeutic management described in people include anti-coagulation, thrombectomy, thrombolysis and pacemaker lead extraction [17,[29][30][31], however evidence-based guidance for clinicians is limited and is usually made on a case-by-case basis. Intravenous administration of heparin followed by warfarin is often used as an initial therapy [31].…”

Section: Discussionmentioning

confidence: 99%

Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study

McGrath

Dixon

Hirst

et al. 2023

Journal of Veterinary Cardiology

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Ultrasound Accelerated Catheter Directed Thrombolysis for Pulmonary Embolus and Right Heart Thrombus Secondary to Transvenous Pacing Wires

Cited by 6 publications

References 17 publications

Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters

Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters

Pulmonary Thromboembolism and Myocarditis Resulting from a Large Pacing-Lead-Associated Right Ventricular Thrombus in a Dog with Chronic Cough as Presenting Sign

Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study

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