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Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up
(1) 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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537142/ https://www.ncbi.nlm.nih.gov/pubmed/34682839 http://dx.doi.org/10.3390/jcm10204716 |
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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, Xavier Santos, Salud Riera-Mestre, Antoni |
author_facet | Ribas, Jesús Valcárcel, Joana Alba, Esther Ruíz, Yolanda Cuartero, Daniel Iriarte, Adriana Mora-Luján, José María Huguet, Marta Cerdà, Pau Martínez-Yélamos, Sergio Corbella, Xavier Santos, Salud Riera-Mestre, Antoni |
author_sort | Ribas, Jesús |
collection | PubMed |
description | (1) 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. |
format | Online Article Text |
id | pubmed-8537142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85371422021-10-24 Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up Ribas, Jesús Valcárcel, Joana Alba, Esther Ruíz, Yolanda Cuartero, Daniel Iriarte, Adriana Mora-Luján, José María Huguet, Marta Cerdà, Pau Martínez-Yélamos, Sergio Corbella, Xavier Santos, Salud Riera-Mestre, Antoni J Clin Med Article (1) 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. MDPI 2021-10-14 /pmc/articles/PMC8537142/ /pubmed/34682839 http://dx.doi.org/10.3390/jcm10204716 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ribas, Jesús Valcárcel, Joana Alba, Esther Ruíz, Yolanda Cuartero, Daniel Iriarte, Adriana Mora-Luján, José María Huguet, Marta Cerdà, Pau Martínez-Yélamos, Sergio Corbella, Xavier Santos, Salud Riera-Mestre, Antoni Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title | Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title_full | Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title_fullStr | Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title_full_unstemmed | Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title_short | Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up |
title_sort | catheter-directed therapies in patients with pulmonary embolism: predictive factors of in-hospital mortality and long-term follow-up |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537142/ https://www.ncbi.nlm.nih.gov/pubmed/34682839 http://dx.doi.org/10.3390/jcm10204716 |
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