CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2018; 02(01): 017-022
DOI: 10.1055/s-0038-1642108
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Massive Pulmonary Embolism Thrombolysis: Early Clinical Markers of Treatment Efficacy

Elie Portnoy
1  Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Vibhor Wadhwa
2  Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
,
Mariana de Carvalho Barbosa
3  Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brazil
,
Clifford R. Weiss
1  Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Brian Holly
1  Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Mark L. Lessne
1  Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
4  Vascular and Interventional Specialists of Charlotte Radiology, Charlotte, North Carolina, United States
,
Kelvin Hong
1  Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Anobel Tamrazi
5  Division of Vascular and Interventional Radiology, Palo Alto Medical Foundation
› Author Affiliations
Further Information

Publication History

Received: 29 July 2017

Accepted: 09 January 2018

Publication Date:
03 May 2018 (online)

Abstract

The authors seek to evaluate hemodynamic parameters as potential clinical markers of real-time clinical improvement among patients with massive pulmonary embolism (PE) in correlation with post-thrombolytic pulmonary arterial pressure improvement and overall clinical outcome. Thirteen patients with submassive or massive PE were admitted to the interventional radiology service and treated with catheter-directed thrombolysis. Among the four patients who qualified as massive PE, systolic blood pressure (BP) and vasopressor dependence suggested meaningful trends toward clinical improvement, after only 26.4% of treatment course/dose. Hemodynamic parameters such as systolic BP and inotropic vasopressor dependence may be considered in future treatment protocols as early indicators of treatment response.