Kong Nathan W, Acosta Mary, Zahid Arslan, Clarke Michael, Bandealy Nadeem, Teerapuncharoen Krittika, Luchetti Hadleigh, Serritella Anthony, Shah Atman P, Nathan Sandeep, Kalathiya Rohan, Blair John, Ahmed Osman, Bag Remzi, Paul Jonathan
Department of Internal Medicine, University of Chicago, Chicago, Illinois.
Department of Internal Medicine, Section of Pulmonary/Critical Care Medicine, University of Chicago, Chicago, Illinois.
J Soc Cardiovasc Angiogr Interv. 2023 Feb 24;2(3):100602. doi: 10.1016/j.jscai.2023.100602. eCollection 2023 May-Jun.
Guidelines on the management of acute pulmonary embolism (PE) recommend consideration of endovascular therapies (EVT) for patients at intermediate-high risk. However, long-term data on the outcomes of patients after EVT as compared to medical therapy is lacking. This study aimed to compare outcomes of patients receiving EVT as compared to medical therapy alone at 3 to 6 months.
In this single-center, retrospective cohort study, 190 patients with PE underwent evaluation for presence of right ventricular (RV) dysfunction by transthoracic echocardiogram, residual perfusion defects on ventilation-perfusion scanning, and functional capacity by 6-minute walk distance (6MWD) at 3 to 6 month follow-up.
Fifty-eight (31%) patients received EVT for the management of their acute PE. At follow-up (median 120 [97-170] days), 71% of patients who received EVT had normalization of RV function compared with only 34% of patients who received medical therapy alone (001). Patients who received EVT had a significantly greater increase in their estimated glomerular filtration rate (001), decrease in N-terminal proB-type natriuretic peptide (003), and decrease in hemoglobin values (018). Patients with intermediate-high to high risk PE who received EVT had significantly greater distance achieved on their 6MWD as compared to those who received medical therapy alone (025).
Patients with acute PE who received EVT plus medical therapy were more likely to achieve normalization of RV dysfunction at 3 to 6 month follow-up compared to patients who received medical therapy alone. These data suggest that EVT is an effective therapy option for acute PE in intermediate-high and high risk patients with potential durable long-term benefits.
急性肺栓塞（PE）管理指南建议，对于中高危患者可考虑采用血管内治疗（EVT）。然而，与药物治疗相比，关于EVT治疗后患者长期预后的数据尚缺乏。本研究旨在比较接受EVT治疗与单纯药物治疗的患者在3至6个月时的预后情况。
在这项单中心回顾性队列研究中，190例PE患者在3至6个月随访时，通过经胸超声心动图评估右心室（RV）功能障碍情况、通气灌注扫描评估残余灌注缺损，并通过6分钟步行距离（6MWD）评估功能能力。
58例（31%）患者接受了EVT治疗急性PE。在随访时（中位时间120 [97 -
