Login
Search
Search
0 Dates
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Comparative Outcomes of In Situ Fibrinolysis Versus Mechanical and Combined Techniques in Reducing Right Heart Pressures and Mortality in Pulmonary Embolism Patients
Session:
SESSÃO DE POSTERS 58 – TROMBOEMBOLISMO
Speaker:
Mariana Caetano Coelho
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Mariana Caetano Coelho; Julien Lopes; Bárbara Lacerda Teixeira; André Grazina; João Reis; Ana Galrinho; Duarte Nuno Cacela; Rúben Ramos; Melanie Ferreira; Rui Cruz Ferreira; Luís Almeida Morais
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Introduction: Pulmonary embolism (PE) is a life-threatening condition caused by acute obstruction of pulmonary arteries, leading to increased right ventricular pressure, hemodynamic compromise, and potentially death. Management varies by severity, from anticoagulation in stable cases to advanced interventions in higher-risk presentations. Recent interest has focused on interventional treatments, including in situ fibrinolysis, mechanical thrombectomy (MT) devices like FlowTriever and Penumbra, and hybrid approaches. These techniques aim to improve thrombus resolution with lower systemic risks compared to fibrinolysis alone. However, randomized trials comparing the safety and efficacy of MT and catheter-directed thrombolysis (CDT) are limited, leaving their impact on right-sided pressures, mortality, and clinical outcomes unclear.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Aim: This study aims to compare the effectiveness of in situ fibrinolysis with mechanical and combined therapies (CT) in reducing right heart pressures and improving survival in patients with acute PE, contributing to the ongoing effort to refine and personalize PE treatment strategies.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Results: A total of 98 patients with intermediate-low or higher risk PE were enrolled from 2020 to 2024: 69 in the CDT arm and 29 in the MT/CT arm (8 CT and 21 MT using Penumbra or FlowTriever). Most patients had intermediate-high risk PE, with more high-risk cases in the MT/CT arm (21%). Dyspnea was the most common symptom in both groups. History of DVT was the main risk factor in the CDT arm (17%), while active cancer was more frequent in the MT/CT arm (10%). ICU stays were slightly longer in the MT/CT group (4.7 vs. 3.7 days).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">At the 3-month follow-up, no significant differences were observed between the CDT and MT/CT groups in systolic, diastolic, or mean pulmonary artery pressures (PAP). Systolic PAP was 17 ± 2 mmHg for CDT and 18 ± 4 mmHg for MT/CT (p = 0.586); diastolic PAP was 7 ± 1 mmHg and 6 ± 2 mmHg (p = 0.878); mean PAP was 10 ± 1 mmHg and 10 ± 2 mmHg (p = 0.896). Right ventricular function improvement was also similar between groups: 2 ± 1 for CDT and 1 ± 2 for MT/CT (p = 0.57).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Complication rates were similar between CDT and MT/CT groups (6% vs. 10%). In the CDT group, complications included progression to cardiogenic shock, peripheral hemorrhage, and one case of recurrent deep vein thrombosis. The MT/CT group experienced pulmonary artery dissection, alveolar hemorrhage, and one case of recurrent PE. Six patients in the CDT group developed CTEPH, while no CTEPH cases occurred in the MT/CT group. Cardiovascular mortality was low, with one death in the CDT group due to refractory cardiogenic shock.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Conclusions: Both CDT and MT/CT are effective for treating pulmonary embolism. The CDT group had more hemorrhagic complications, while the MT/CT group showed higher mechanical complication rates. Treatment choice should consider individual risk profiles for hemorrhagic or mechanical events.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site