The use of catheter-directed thrombolysis saves lives and should be considered a first-line treatment option for massive pulmonary embolism, according to a study in the November issue of the Journal of Vascular and Interventional Radiology.
Catheter-directed thrombolysis is an interventional radiology treatment that uses targeted image-guided delivery with specially designed catheters to dissolve lung blood clots. William Kuo, MD, department of radiology, Stanford University Medical Center in Stanford, Calif., and colleagues conducted a meta-analysis of that treatment in 594 patients in 18 countries between 1990 and 2008.
The treatment involves the insertion of the catheter by an interventional radiologist into a patient’s blood vessels. The radiologist guides the catheter using real-time imaging without traditional open surgery, which allows the radiologist to deliver a medication directly to the clot that will break it up. The radiologist can also mechanically break up clots and suction them out.
According to the study, the procedure was lifesaving in 86.5 percent of the cases studied and had just a 2.4 percent chance of resulting in major complications.
"Modern catheter-directed therapy for acute pulmonary embolism saves lives, and we need to raise awareness about its safety and effectiveness not only among the general public but also within the medical community. It's a matter of life and death," said Kuo. "In our study, we conclude that modern catheter-directed therapy is a relatively safe and effective treatment for acute massive pulmonary embolism and should be considered as a first-line treatment option," he added.
Kuo said that additional studies are needed to see if the treatment should be used in patients with less severe pulmonary embolism.