The efficacy of Pharmacomechanical catheter-directed thrombolysis in patients with concomitant deep vein thrombosis and pulmonary embolism: A retrospective analysis of 26 patients

This study aimed to analyze the impact of pharmacomechanical catheter-directed thrombolysis (PCDT) on venous patency, pulmonary artery systolic pressure, O2 saturation and in-hospital mortality in patients admitted for deep vein thrombosis (DVT) and concomitant pulmonary embolism (PE).
Twenty-six patients presenting with DVT and concomitant non-massive PE were analyzed in aretrospective manner. All subjects underwent PCDT with urokinase. The primary end-point of this study was the difference in pre-and post PCDT sPAP and O2 saturation. Duplex ultrasonography performed before discharge revealed complete recanalization of the compromised vein in 21 (80%) of the subjects. Duplex ultrasonography performed 3 months after discharge showed restenosis of the compromised vein in only two patients (8%). There was partial recanalization in 5 patients (20%). A significant improvement in SaO2 was observed following the infusion of urokinase compared to baseline values (94.5±1.1 % vs. 98.6±0.5 %, p<0.001). The presenting sPAP was 48.6±7.9 mmHg and the final sPAP measured before discharge was 28.4±2.7 mmHg (p<0.001). Recurrent PE, major bleeding and mortality was not observed in any of the subjects. Findings of this study including patients with concomitant DVT and non-massive PE has shown that PCDT provides excellent result concerning venous patency, oxygenation and pulmonary hemodynamics in the acute and short-term setting.