Khalil Hisham H, Aboaly Safwat, Alkhalifah Saleh, Almossabeh Modhahir, Alsayegh Ibrahim H, Al Sulaiman Zuhair
Cardiology, Almoosa Specialist Hospital, Al Mubarraz, SAU.
Pulmonology, Almoosa Specialist Hospital, Al Mubarraz, SAU.
Cureus. 2025 Mar 27;17(3):e81303. doi: 10.7759/cureus.81303. eCollection 2025 Mar.
Pulmonary embolism (PE) is a life-threatening condition associated with significant morbidity and mortality. While systemic thrombolysis is effective in high-risk cases, it carries a substantial risk of bleeding complications. Ultrasound-assisted catheter-directed thrombolysis (UCDT) has emerged as a promising alternative, enhancing clot resolution while minimizing hemorrhagic risks. This case series presents three patients with high-risk and intermediate-high-risk PE who underwent UCDT. All patients exhibited hemodynamic instability and right ventricular dysfunction. Following UCDT, significant clinical and echocardiographic improvements were observed, with no major bleeding complications. UCDT represents a targeted thrombolysis approach that optimizes clot dissolution while reducing systemic thrombolytic exposure. Current evidence supports UCDT as an effective and safer alternative for select PE patients, though further randomized studies are needed to refine patient selection and standardize treatment protocols. This case series highlights the clinical benefits of UCDT and reinforces its role as a viable treatment strategy.
肺栓塞（PE）是一种危及生命的疾病，伴有显著的发病率和死亡率。虽然全身溶栓在高危病例中有效，但它具有出血并发症的重大风险。超声辅助导管定向溶栓（UCDT）已成为一种有前景的替代方法，可提高血栓溶解率，同时将出血风险降至最低。本病例系列介绍了三名接受UCDT治疗的高危和中高危PE患者。所有患者均表现出血流动力学不稳定和右心室功能障碍。UCDT治疗后，观察到显著的临床和超声心动图改善，且无重大出血并发症。UCDT是一种靶向溶栓方法，可优化血栓溶解，同时减少全身溶栓暴露。目前的证据支持UCDT作为某些PE患者有效且更安全的替代方法，不过还需要进一步的随机研究来优化患者选择并规范治疗方案。本病例系列突出了UCDT的临床益处，并强化了其作为可行治疗策略的作用。
