Short report
Management of pulmonary thrombo-embolism using catheter
manipulation: a report of four cases and review of the literature
Peter S C Wong, Shyam P Singh, Robert D S Watson, Gregory Y H Lip
Department
of Cardiology, City Hospital, Dudley Road, Birmingham B18 7QH, UK
Correspondence to: Dr GYH Lip
Accepted 7 June 1999
To date the management of pulmonary thrombo-embolism is still
largely limited to anticoagulation. Heparin and oral anticoagulation have been shown to be effective in reducing recurrence and death in
venous thrombo-embolism. During the acute stage, systemic thrombolytic therapy has also been advocated for the rapid dissolution of the thrombus in patients with haemodynamic instability. We describe four
patients with acute pulmonary thrombo-embolism who were managed with
catheter-based thrombus manipulation with intrapulmonary thrombolysis.
This management strategy should be considered in patients with
pulmonary thrombo-embolism who continue to deteriorate despite
conventional management with anticoagulation or systemic thrombolysis.
Keywords: pulmonary thrombo-embolism; catheter manipulation; thrombus; thrombolytic therapy
© 1999 by The Fellowship of Postgraduate Medicine
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