Bilateral EKOS EndoWave catheter thrombolysis of acute bilateral pulmonary embolism in a hemodynamically unstable patient.

Pulmonary embolism is a common and sometimes devastating disease caused by many factors, most commonly deep venous thrombosis. Treatment is typically systemic anticoagulation depending on patient clinical presentation. For patients with life threatening pulmonary embolism, IV tPA (Activase, Genentech, South San Francisco, CA) is the most common medication given emergently at the time of presentation. Computed tomography angiography (CTA) of the chest has advanced the diagnosis and potential treatment options for patients with life threatening pulmonary embolism. Combination percutaneous transcatheter directed pharmacological and mechanical thrombolysis has become extremely useful in these difficult cases.