Intravascular ultrasound‐guided pulmonary artery embolectomy for saddle pulmonary embolism

A percutaneous catheter‐directed treatment approach is preferred among patients with acute submassive pulmonary embolism (PE) and chronic kidney disease (CKD), who are at significant risk of bleeding with thrombolytics. Limiting contrast volume in these patients could reduce morbidity and mortality...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2021-02, Vol.97 (3), p.E385-E389
Main Authors: Effoe, Valery S., Kumar, Gautam, Sachdeva, Rajesh
Format: Article
Language:English
Subjects:
Angiography
Blood pressure
Calcium-binding protein
Catheterization
Catheters
Computed tomography
Dyspnea
Echocardiography
Edema
embolectomy
Embolism
Emergency medical care
Fluoroscopy
Hemoglobin
Intravenous administration
intravenous contrast
Kidney diseases
Morbidity
Oxygen
Pulmonary arteries
Pulmonary artery
pulmonary embolism
Pulmonary embolisms
renal failure
Respiration
thrombectomy
Troponin
Ultrasonic imaging
Ultrasound
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Summary:A percutaneous catheter‐directed treatment approach is preferred among patients with acute submassive pulmonary embolism (PE) and chronic kidney disease (CKD), who are at significant risk of bleeding with thrombolytics. Limiting contrast volume in these patients could reduce morbidity and mortality associated with contrast‐induced acute kidney injury (CI‐AKI). We present the case of a 61‐year‐old African American woman (BMI 46.9 kg/m2) with multiple comorbidities, including a PE 3 years prior (not currently on anticoagulation) and CKD (GFR 33 ml/min/1.73/m2), presented to the emergency department with 3 weeks of dyspnea on exertion which worsened 3–5 days preceding her presentation. On examination, she was hemodynamically stable, oxygen saturation was 88% on 5 l, in mild respiratory distress with bilateral lower extremity pitting edema. Troponin was 0.06 ng/ml (ref.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.28985