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
Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Vibhor Wadhwa
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
,
Mariana de Carvalho Barbosa
Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brazil
,
Clifford R. Weiss
Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Brian Holly
Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Mark L. Lessne
Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Vascular and Interventional Specialists of Charlotte Radiology, Charlotte, North Carolina, United States
,
Kelvin Hong
Division of Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
,
Anobel Tamrazi
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.