1 Department of General Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
2 Division of Cardiovascular Diseases, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
Angiology. 2017 Jul;68(6):494-501. doi: 10.1177/0003319716665718. Epub 2016 Sep 7.
Intermediate-risk pulmonary embolism (PE), also known as submassive PE, occurs in a substantial group of patients and carries a significant mortality risk. With adequate risk stratification, catheter-directed techniques could be used as a therapeutic approach in the intermediate-risk PE. Ultrasound-assisted catheter-directed thrombolysis (UCDT) represents a novel endovascular technique with good clinical and safety outcomes. Ultrasound-assisted catheter-directed thrombolysis can achieve reduction in the thrombus burden and improvement of pulmonary hemodynamics and right ventricular (RV) dysfunction and/or dilatation, without major procedure-related complications, major bleeding, or hemorrhagic strokes. This narrative review will focus on the major studies involving the efficacy and safety of UCDT in the intermediate-risk PE population. Prospective, randomized clinical trials with long-term follow-up and a large sample size are needed for further evaluation of mortality benefit and to further define which subgroup of patients may benefit from this novel endovascular technique.
中危肺栓塞（PE），亦称次大面积 PE，在相当一部分患者中发生，且具有显著的死亡风险。充分的风险分层后，导管介入技术可作为中危 PE 的一种治疗方法。超声辅助的导管内溶栓（UCDT）是一种新型的血管内技术，具有良好的临床和安全性结果。超声辅助的导管内溶栓可降低血栓负荷，改善肺血流动力学和右心室（RV）功能障碍和/或扩张，且无主要与操作相关的并发症、大出血或出血性中风。本综述将重点介绍 UCDT 在中危 PE 人群中的疗效和安全性的主要研究。需要进一步评估死亡率获益的前瞻性、随机临床试验，并进行长期随访和大样本量研究，以进一步确定哪些亚组患者可能从这种新型血管内技术中获益。
