Saylan Bengü, Çalışkan Tayfun, Canoğlu Kadir, Ulucan Ali Ertan, Yılmaz Ahmet Turan
Department of Pulmonology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Cardiovascular Surgery, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Apr 22;28(2):301-307. doi: 10.5606/tgkdc.dergisi.2020.19133. eCollection 2019 Jun.
The aim of this study was to evaluate the efficacy and the safety of the EkoSonic™ endovascular system applications in patients hospitalized with the diagnosis of intermediate-high-risk pulmonary embolism.
Between January 2018 and March 2019, a total of 15 patients (7 males, 8 females; mean age 64.7±17.8 years, range, 35 to 90 years) who underwent ultrasound-accelerated thrombolysis using the EkoSonic™ endovascular system for pulmonary embolism were retrospectively analyzed. The diagnosis of pulmonary embolism was made based on pulmonary computed tomography angiography. All patients were evaluated by echocardiography for right ventricular dysfunction and serum levels of troponin I and brain natriuretic peptide were recorded.
The mean arterial blood gas oxygen saturation values of the patients before and after the procedure were 86.3±3.5% and 94.2±2.5%, respectively, indicating a statistically significant difference (p=0.001). The mean partial oxygen pressure values before and after the procedure were 73.3±7.7 mmHg and 90.7±5.0 mmHg, respectively, indicating a statistically significant difference (p=0.001). There was also a statistically significant difference in the mean right ventricular diameter before and after the procedure (p=0.001). The mean pre- and post-procedural pulmonary arterial pressure was 44±7.1 mmHg and 36.3±4.5 mmHg, respectively, indicating a statistically significant difference (p=0.001). Of the patients, 93.7% were free from post-procedural complications.
The EkoSonic™ endovascular system improved right ventricular dysfunction, decreased pulmonary arterial pressure, and improved oxygenation in patients with intermediate-high-risk pulmonary embolism without increasing the risk for bleeding.
本研究的目的是评估EkoSonic™血管内系统应用于中高危肺栓塞住院患者的疗效和安全性。
回顾性分析2018年1月至2019年3月期间，共15例（7例男性，8例女性；平均年龄64.7±17.8岁，范围35至90岁）使用EkoSonic™血管内系统进行超声加速溶栓治疗肺栓塞的患者。肺栓塞的诊断基于肺部计算机断层扫描血管造影。所有患者均通过超声心动图评估右心室功能障碍，并记录肌钙蛋白I和脑钠肽的血清水平。
患者术前和术后的平均动脉血气氧饱和度值分别为86.3±3.5%和94.2±2.5%，差异有统计学意义（p=0.001）。术前和术后的平均氧分压值分别为73.3±7.7 mmHg和90.7±5.0 mmHg，差异有统计学意义（p=0.001）。术前和术后的平均右心室直径也有统计学差异（p=0.001）。术前和术后的平均肺动脉压分别为44±7.1 mmHg和36.3±4.5 mmHg，差异有统计学意义（p=0.001）。93.7%的患者术后无并发症。
EkoSonic™血管内系统可改善中高危肺栓塞患者的右心室功能障碍，降低肺动脉压，改善氧合，且不增加出血风险。
