Catheter-directed therapy for acute pulmonary embolism: results of a multicenter national registry.

Abstract

INTRODUCTION AND OBJECTIVES:

Catheter-directed therapy (CDT) for acute pulmonary embolism (PE) is an emerging therapy that combines heterogeneous techniques. The aim of the study was to provide a nationwide contemporary snapshot of clinical practice and CDT-related outcomes.

METHODS:

This Investigator-initiated multicenter registry aimed to include consecutive patients with intermediate-high risk (IHR) or high-risk (HR), acute PE eligible for CDT. The primary outcome of the study was in-hospital all-cause death.

RESULTS:

A total of 253 patients were included, of whom 93 (36.8%) had HR-PE, and 160 (63.2%) had IHR-PE with a mean age of 62.3±15.1 years. Local thrombolysis was performed in 70.8% and aspiration thrombectomy in 51.8%, with 23.3% of patients receiving both. However, aspiration thrombectomy was favored in the HR-PE cohort (80.6% vs 35%; P<.001). Only 51 patients (20.2%) underwent CDT with specific PE devices. The success rate for CDT was 90.9% (98.1% of IHR-PE patients vs 78.5% of HR-PE patients, P<.001). In-hospital mortality was 15.5%, and was highly concentrated in the HR-PE patients (37.6%) and significantly lower in IHR-PE patients (2.5%), P<.001. Long-term (24-month) mortality was 40.2% in HR-PE patients vs 8.2% in IHR-PE patients (P<.001).

CONCLUSIONS:

Despite the high success rate for CDT, in-hospital mortality in HR-PE is still high (37.6%) compared with very low IHR-PE mortality (2.5%).

• Authors: Pablo Salinas, María-Eugenia Vázquez-Álvarez, Neus Salvatella, Valeriano Ruiz Quevedo, Maite Velázquez Martín, Ernesto Valero, Eva Rumiz, Alfonso Jurado-Román, Íñigo Lozano, Fernando Gallardo, Ignacio J Amat-Santos, Óscar Lorenzo, Juan José Portero Portaz, Mike Huanca, Luis Nombela-Franco, Beatriz Vaquerizo, Raúl Ramallal Martínez, Nicolás Manuel Maneiro Melón, Juan Sanchis, Alberto Berenguer, Arsenio Gallardo-López, Enrique Gutiérrez-Ibañes, Hernán Mejía-Rentería, Juan Gabriel Córdoba-Soriano, Jesús María Jiménez-Mazuecos
• Journal: Revista espanola de cardiologia (English ed.) (Rev Esp Cardiol (Engl Ed)) Vol. 77 Issue 2 Pg. 138-147 (Feb 2024) ISSN: 1885-5857 [Electronic] Spain
• PMID: 37354942 (Publication Type: Multicenter Study, Journal Article)
• Copyright: Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Chemical References

• Fibrinolytic Agents

Topics

• Humans
• Middle Aged
• Aged
• Fibrinolytic Agents (therapeutic use)
• Thrombolytic Therapy (methods)
• Treatment Outcome
• Pulmonary Embolism (therapy)
• Thrombectomy (methods)
• Catheters
• Registries
• Retrospective Studies