Al-Terki Hani, Elhakim Abdelrahman, Mügge Andreas
Cardiology and Rhythmology Department, University Hospital St Josef-Hospital Bochum, Ruhr University Bochum, Gudrunstraße 56, 44791 Bochum, Germany.
Cardiology Department, Schoen Hospital, 23730 Neustadt in Holstein, Germany.
J Clin Med. 2023 Apr 4;12(7):2712. doi: 10.3390/jcm12072712.
Pulmonary embolism (PE) is a common cardiovascular disease. Elderly patients with acute PE have very high mortality rates. Data concerning the safety and effectiveness of ultrasound-accelerated thrombolysis (USAT) in this age group are lacking.
Nineteen octogenarians with acute pulmonary embolism underwent USAT between August 2020 and February 2023 at two centres in Germany and were retrospectively analysed. The main efficacy measures were the right ventricle to left ventricle diameter (RV/LV) ratio, systolic right ventricle function, and invasive and echocardiographic measured systolic pulmonary artery pressure (sPAP). The main safety measures were in-hospital death and the bleeding rate according to the GUSTO bleeding score.
USAT was associated with an improved RV/LV ratio (0.36 ± 0.29, < 0.001), systolic right ventricle function (5.0 ± 3.8, < 0.001), and systolic pulmonary artery pressure (sPAP) at 24 h after therapy (24.2 ± 11.2 mmHg and 19 ± 13.4 mmHg, < 0.001). No in-hospital deaths or bleeding complications occurred.
USAT with EKOS may be a safe and effective therapeutic option for octogenarians with acute pulmonary embolism.
肺栓塞（PE）是一种常见的心血管疾病。老年急性肺栓塞患者的死亡率非常高。目前缺乏关于超声加速溶栓（USAT）在该年龄组中的安全性和有效性的数据。
对2020年8月至2023年2月期间在德国两个中心接受USAT治疗的19名急性肺栓塞的八旬老人进行回顾性分析。主要疗效指标为右心室与左心室直径（RV/LV）比值、右心室收缩功能以及有创和超声心动图测量的收缩期肺动脉压（sPAP）。主要安全指标为住院死亡率和根据GUSTO出血评分得出的出血率。
USAT与治疗后24小时时改善的RV/LV比值（0.36±0.29，<0.001）、右心室收缩功能（5.0±3.8，<0.001）以及收缩期肺动脉压（sPAP）（24.2±11.2 mmHg和19±13.4 mmHg，<0.001）相关。未发生住院死亡或出血并发症。
对于急性肺栓塞的八旬老人，采用EKOS的USAT可能是一种安全有效的治疗选择。
