Fava Mario, Loyola Soledad, Meneses Luis
Departamento de Radiología, Hospital Clínico Pontificia Universidad Católica de Chile.
Rev Med Chil. 2005 Dec;133(12):1477-82. doi: 10.4067/s0034-98872005001200010. Epub 2006 Jan 27.
Pulmonary Embolism (PE) has a wide clinical spectrum. It is imperative to detect patients with a high risk to develop right ventricular failure, because this is the main cause of death in patients with massive PE. In this group of patients, invasive therapies to relieve pulmonary obstruction and right ventricle overload should be used as soon as possible. We report a 85 years old male with massive PE treated with pharmacological thrombolysis and mechanical fragmentation with an angioplasty balloon. Pulmonary perfusion improved significantly. Afterwards, systemic anticoagulation was started and an inferior vena cava filter was installed percutaneously. The patient was discharged in good conditions, five days after admission.
肺栓塞（PE）临床表现多样。识别有发生右心室衰竭高风险的患者至关重要，因为这是大面积PE患者的主要死因。对于这类患者，应尽快采用有创治疗以缓解肺阻塞和右心室负荷过重。我们报告一例85岁男性大面积PE患者，接受了药物溶栓及血管成形术球囊机械碎栓治疗。肺灌注显著改善。之后开始全身抗凝治疗，并经皮植入下腔静脉滤器。患者入院五天后情况良好出院。
