%0 Journal Article
%T Retrospective comparison of ultrasound facilitated catheter
%A Alan Awdisho
%A Bethany Schroeder
%A Curt Bay
%A Jos¨¦ Jim¨¦nez
%A Mohsen Sharifi
%A Priya Iyer
%J Vascular Medicine
%@ 1477-0377
%D 2019
%R 10.1177/1358863X18824159
%X This study retrospectively compared the outcomes of patients who received ultrasound facilitated catheter-directed thrombolysis (UFCDT) versus systemically administered ¡®half-dose¡¯ thrombolysis (HDT) in 97 patients with PE. The outcomes assessed included changes in baseline pulmonary artery systolic pressure (PASP), right ventricle/left ventricle ratio (RV/LV), cost and duration of hospitalization, death, bleeding, and recurrent venous thromboembolism in the short and intermediate term follow-up. Analyses were performed using a covariance adjustment propensity score approach to address baseline differences between groups in variables associated with PASP and RV/LV, covarying baseline scores. The baseline mean ¡À SE PASP dropped from 49.3 ¡À 1.1 to 32.5 ¡À 0.3 mmHg at 36 hours in the HDT group, and from 50.6 ¡À 1.2 to 35.1 ¡À 0.4 mmHg in the UFCDT group; group ¡Á time interaction p-value = 0.007. Corresponding drops in the RV/LV were from a baseline of 1.26 ¡À 0.05 to 1.07 ¡À 0.01 in the HDT group and from 1.30 ¡À 0.05 to 1.14 ¡À 0.01 in the UFCDT group at 36 hours; group ¡Á time interaction p-value = 0.269. Statistically significant decreases were noted in PASP and RV/LV for both the HDT and UFCDT at 36 hours and follow-up. PASP through follow-up was significantly lower in the HDT than the UFCDT group. Likewise, RV/LV was lower in the HDT group. The duration and cost of hospitalization were lower in the HDT group (6.2 ¡À 1.4 days vs 1.9 ¡À 0.3 days, p < 0.001; US$12,000 ¡À $3000 vs $74,000 ¡À $6000, p < 0.001). We conclude that both UFCDT and HDT lead to rapid reduction of PASP and RV/LV, whereas HDT leads to a lower duration and cost of hospitalization
%K anticoagulants
%K embolus
%K pulmonary embolism (PE)
%K catheter-directed thrombolysis
%K systemic thrombolysis
%K thrombus
%U https://journals.sagepub.com/doi/full/10.1177/1358863X18824159