Feasibility of ultrasound‐assisted catheter‐directed thrombolysis for submassive pulmonary embolism: A meta‐analysis of case series

Background During the past few years, there has been a surge in the use of ultrasound‐assisted catheter‐directed thrombolysis (UACDT) for submassive pulmonary embolism (SPE). However, few studies evaluated the feasibility of UACDT for SPE. Purpose To evaluate the feasibility of UACDT in treating SPE...

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Bibliographic Details
Published in:The clinical respiratory journal 2020-05, Vol.14 (5), p.430-439
Main Authors: Wu, Jiayan, Chen, Haiming, Yu, Yongqin, Peng, Lingsheng, Li, Jieying, Liang, Hengrui, Ba, Manqing, Ruan, Honglian, Hong, Cheng
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
case series
Catheters
Embolisms
Evaluation Studies as Topic
feasibility
Feasibility Studies
Female
Hemorrhage - epidemiology
Hemorrhage - etiology
Hospital Mortality - trends
Humans
Male
Meta-analysis
Middle Aged
Pulmonary arteries
Pulmonary Embolism - therapy
Pulmonary embolisms
submassive pulmonary embolism
Thrombolytic Therapy - adverse effects
Thrombolytic Therapy - instrumentation
Treatment Outcome
Ultrasonic imaging
Ultrasonography, Interventional - methods
ultrasound‐assisted catheter‐directed thrombolysis
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Summary:Background During the past few years, there has been a surge in the use of ultrasound‐assisted catheter‐directed thrombolysis (UACDT) for submassive pulmonary embolism (SPE). However, few studies evaluated the feasibility of UACDT for SPE. Purpose To evaluate the feasibility of UACDT in treating SPE. Methods A comprehensive search of online databases was performed. Search terms UACDT in SPE were entered into PubMed, Embase, Scopus and the Cochrane Library to identify related articles published until October 2018. A quality assessment and data extraction were performed by two researchers. Meta‐analysis was performed using R statistical software. Results Twelve studies with 485 patients were included in this meta‐analysis. The pooled right ventricular/left ventricular ratio decrease and pulmonary artery systolic pressure drop after treatment was −0.34 (95% CI: −0.43, −0.25) and −15.05 (95% CI: −18.10, −12.00) mm Hg, respectively. The pooled major bleeding rate was 1.0% (95% CI: 0.0%, 3.0%), and the in‐hospital mortality was 0.0% (95% CI: 0.0%, 1.0%). Conclusion This up to data meta‐analysis confirms that UACDT is a feasible treatment for SPE.
ISSN:1752-6981
1752-699X
DOI:10.1111/crj.13155