Chan Shin Mei, Laage Gaupp Fabian M, Lee Jessica M, Pollak Jeffrey S, Khosla Akhil
Yale School of Medicine, New Haven, CT, USA.
Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
SAGE Open Med Case Rep. 2022 Jul 12;10:2050313X221112361. doi: 10.1177/2050313X221112361. eCollection 2022.
Pulmonary embolisms can affect 0.9 in 100,000 children and carry high risk for mortality. However, management of pediatric pulmonary embolism is largely derived from adult studies and treatment often includes local or systemic thrombolytics or anticoagulation, which may pose unique bleeding risks in children and adolescents compared with adults. This report describes a case in which catheter-directed embolectomy was used to successfully manage a pediatric patient with high-risk/massive pulmonary embolism. This case suggests that catheter-directed embolectomy is an effective therapy in patients outside the adult population and more research is required to expand inclusion criteria for current catheter-directed embolectomy treatment paradigms. Moreover, this case emphasizes the need for dedicated pediatric pulmonary embolism response teams to best serve the pediatric population.
肺栓塞在每10万名儿童中约有0.9例发生,且死亡率很高。然而,儿童肺栓塞的治疗方法大多源自成人研究,治疗通常包括局部或全身溶栓或抗凝,与成人相比,这可能给儿童和青少年带来独特的出血风险。本报告描述了一例采用导管定向血栓切除术成功治疗高危/大面积儿童肺栓塞患者的病例。该病例表明,导管定向血栓切除术对成人以外的患者是一种有效的治疗方法,需要更多研究来扩大当前导管定向血栓切除术治疗模式的纳入标准。此外,该病例强调了需要专门的儿童肺栓塞应对团队,以便为儿童群体提供最佳服务。