Catheter-directed therapies in patients with pulmonary embolism: predictive factors of in-hospital mortality and long-term follow-up
Author
Ribas, Jesús
Valcárcel, Joana
Alba, Esther
Ruíz, Yolanda
Cuartero, Daniel
Iriarte, Adriana
Mora-Luján, José María
Huguet, Marta
Cerdà, Pau
Martínez-Yélamos, Sergio
Corbella Virós, Xavier
Santos, Salud
Riera-Mestre, Antoni
Publication date
2021ISSN
2077-0383
Abstract
Background: Catheter-directed therapies (CDT) may be considered for selected patients with pulmonary embolism (PE); (2) Methods: Retrospective observational study including all consecutive patients with acute PE undergoing CDT (mechanical or pharmacomechanical) from January 2010 through December 2020. The aim was to evaluate in-hospital and long-term mortality and its predictive factors; (3) Results: We included 63 patients, 43 (68.3%) with high-risk PE. All patients underwent mechanical CDT and, additionally, 27 (43%) underwent catheter-directed thrombolysis. Twelve (19%) patients received failed systemic thrombolysis (ST) prior to CDT, and an inferior vena cava (IVC) filter was inserted in 28 (44.5%) patients. In-hospital PE-related and all-cause mortality rates were 31.7%; 95% CI 20.6–44.7% and 42.9%; 95% CI 30.5–56%, respectively. In multivariate analysis, age > 70 years and previous ST were strongly associated with PE-related and all-cause mortality, while IVC filter insertion during the CDT was associated with lower mortality rates. After a median follow-up of 40 (12–60) months, 11 more patients died (mortality rate of 60.3%; 95% CI 47.2–72.4%). Long-term survival was significantly higher in patients who received an IVC filter; (4) Conclusions: Age > 70 years and failure of previous ST were associated with mortality in acute PE patients treated with CDT. In-hospital and long-term mortality were lower in patients who received IVC filter insertion.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Procediments endovasculars
Mortalitat
Embòlia pulmonar
Trombectomia
Teràpia trombolítica
Filtres de vena cava
Procedimientos endovasculares
Mortalidad
Embolia pulmonar
Trombectomía
Terapia trombolítica
Filtros de vena cava
Endovascular procedures
Mortality
Pulmonary embolism
Thrombectomy
Thrombolytic therapy
Vena cava filters
Pages
13
Publisher
MDPI
Collection
10; 20
Is part of
Journal of Clinical Medicine
Citation
Ribas, Jesús; Valcárcel, Joana; Alba, Esther [et al.]. Catheter-directed therapies in patients with pulmonary embolism: predictive factors of in-hospital mortality and long-term follow-up. Journal of Clinical Medicine, 2021, 10(20), 4716. Disponible en: <https://www.mdpi.com/2077-0383/10/20/4716>. Fecha de acceso: 22 oct. 2021. DOI: 10.3390/jcm10204716
This item appears in the following Collection(s)
- Ciències de la Salut [740]
Rights
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/