Platelets, Pulmonary Hypertension and Pulmonary Embolism

2015 ◽  
pp. 191-199
Author(s):  
J. F. Cade
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension

scholarly journals Catheter-directed low-dose fibrinolysis infusion for treat acute intermediate-high risk pulmonary embolism

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
MM Martin Cabeza ◽  
MJ Garcia Gonzalez ◽  
P Jorge Perez ◽  
A Sanchez-Grande Flecha ◽  
R Munoz Rodriguez ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Low Dose ◽  
Therapeutic Option ◽  
Bleeding Complications ◽  
Common Disease ◽  
Effective Treatment Option ◽  
Femoral Access ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND  Intermediate-high risk  (IHR) Pulmonary Embolism (PE) are a common disease witch could have a high mortality. Anticoagulation remains the first therapeutic option, but Catheter-directed therapies are being investigated as a safe and effective treatment option. PURPOSE To evaluate the safety and efficacy of Catheter-directed low-dose fibrinolysis infusion to treat IHR-PE. METHODS Retrospective analysis of 16 patients IHR-PE treated. After performing Right catheterization (RC) and angiogram, Pigtail catheters were located for intrapulmonary infusion of Alteplase 1mg/h/catheter for 24 h (25-30mg/day). Baseline and clinical characteristics, inicial and evolutive echocardiography, also clinical evaluation and echocardiography 6 months after discharge were evaluated.   RESULTS The majority were women (11) and obese (93.8%), aged 22-74 years with cardiovascular risk factors: 5 hypertension, 3 Dyslipidemia, 2 smokers and 3 severe CKD . At admission 11 patients consulted for dyspnea and 5 for syncope; all were hemodynamic stable. 68.8% presented respiratory failure. All had bilateral PE (angiography) and elevation of Nt-proBNP and troponins. The echocardiographic at admission, and its evolution are shown in Table 1.  The invasive measurement of pulmonary hypertension (PH) reflected greater severity than the estimated by echo:  5 (31.3%) Severe PH, 5 (31.3%) Moderate PH and 2 (12.5%) mild PH. At discharge all presented a decrease in PH and 15 (93.8%) improved RV function. 2 patients suffered bleeding complications (relation with femoral access): 1 not severe, 1 severe without mortality; none suffered intracranial hemorrhage. In the evaluation at 6-months: 13 patients (81.3%) where on functional Class I and without PH, 3 patients (18.8%) where in Class II and with mild-PH. CONCLUSION In short-term follow-up, intrapulmonary low-dose fibrinolysis reduces PA pressures and improves RV function, without an increased bleeding complications, especially if femoral access is avoided. However impact on long-term remains unclear. Table 1: Echocardiography evolution.RV function admissionNormal Function1 (6.3%)Mild Dysfunction9 (56.3%)Moderate Dysfunction6 (37.5%)RV Dilatation admissionDilatation 16 (100%)Not dilatation 0 (0%)PH Degree admissionMild PH6 (37.5%)Moderate PH5 (31.3%)Severe PH5 (31.3%)PH Degree 24h-postNot PH1 (6.3%)Mild PH10 (62.5%)Moderate/severe PH5 (31.3%)Improvement RV 24h-postYes14 (87.5%)Not2 (12.5%)RV function dischargeNormal Function16 (100%)Mild Dysfunction0 (0%)Moderate Dysfunction0 (0%)RV Dilatation dischargeDilatation 5 (31.3%)Not dilatation 11 (68.8%)PH Degree dischargeNot PH 9 (56.3%)Mild PH7 (43.8%)Moderate/severe PH0 (0%)RV Right Ventricular; PH: Pulmonary Hypertension,

Pulmonary arterial hypertension and acute and chronic thromboembolism

ESC CardioMed ◽  
2018 ◽  
pp. 406-409
Author(s):  
Thomas Henzler
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Imaging Modality ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Right Ventricular Dysfunction ◽  
Chronic Pulmonary Embolism ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) and acute and chronic pulmonary embolism represent severe cardiovascular diseases with a high mortality if left undiagnosed and untreated. Computed tomography of the chest plays a pivotal role in the diagnosis of all three disorders. In acute pulmonary embolism, computed tomography pulmonary angiography has become the gold-standard imaging modality due to its high diagnostic accuracy, cost-effectiveness, 24-hour availability at most institutions, as well as the ability to diagnose alternative chest pathologies and right ventricular dysfunction within a single examination. In PAH, computed tomography of the chest is also deeply embedded within the diagnostic algorithm in order to exclude other causes of pulmonary hypertension, such as structural lung disease and chronic thromboembolic pulmonary hypertension of left heart disease. This article intends to provide a short overview on imaging techniques and characteristic findings in PAH, as well as acute and chronic pulmonary embolism.

scholarly journals Association of plain computed tomography-determined pulmonary artery-to-aorta ratio with clinical severity of coronavirus disease 2019

2020 ◽  
Vol 10 (4) ◽  
pp. 204589402096949
Author(s):  
Hiromasa Hayama ◽  
Masahiro Ishikane ◽  
Rubuna Sato ◽  
Kohei Kanda ◽  
Noriko Kinoshita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Definitive Diagnosis ◽  
Clinical Severity

Coronavirus disease (COVID-19) is associated with pulmonary hypertension due to pulmonary embolism, which affects subsequent outcomes. However, definitive diagnosis of pulmonary hypertension is difficult because of the risk of spreading the infection. Here, we assess the utility of plane computed tomography in noninvasively predicting the clinical severity of COVID-19.

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