TY - JOUR
T1 - Successful pharmaco-invasive approach using a lower alteplase dose and VA-ECMO support in high-risk pulmonary embolism
T2 - case report
AU - Gutierrez-Gallegos, Paola
AU - Jimenez-Franco, Vicente
AU - Jerjes-Sanchez, Carlos
AU - Quevedo-Salazar, Renata
AU - Rodriguez-Rivera, Jahir
AU - Paredes-Gutierrez, Enrique
AU - Lira-Lozano, Daniel
AU - Quintanilla-Gutierrez, Juan
AU - Gomez-Gutierrez, Rene
AU - de la Peña-Almaguer, Erasmo
AU - Torre-Amione, Guillermo
N1 - Publisher Copyright:
2024 Gutierrez-Gallegos, Jimenez-Franco, Jerjes-Sanchez, Quevedo-Salazar, Rodriguez-Rivera, Paredes-Gutierrez, Lira-Lozano, Quintanilla-Gutierrez, Gomez-Gutierrez, de la Peña-Almaguer and Torre-Amione.
PY - 2024
Y1 - 2024
N2 - Despite the elevated mortality rates associated with high-risk pulmonary embolism (PE), this condition remains understudied. Data regarding the effectiveness and safety of invasive therapies such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) in this patient population remains controversial. Here, we present the case of a 61-year-old male with high-risk PE associated with refractory cardiac arrest and cardiogenic shock who underwent a combination of extracorporeal cardiopulmonary resuscitation with VA-ECMO and pharmaco-invasive therapy (mechanical thrombi fragmentation plus lower alteplase dose), resulting in successful pulmonary reperfusion. After a prolonged in-hospital stay, the patient was discharged in stable condition.
AB - Despite the elevated mortality rates associated with high-risk pulmonary embolism (PE), this condition remains understudied. Data regarding the effectiveness and safety of invasive therapies such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) in this patient population remains controversial. Here, we present the case of a 61-year-old male with high-risk PE associated with refractory cardiac arrest and cardiogenic shock who underwent a combination of extracorporeal cardiopulmonary resuscitation with VA-ECMO and pharmaco-invasive therapy (mechanical thrombi fragmentation plus lower alteplase dose), resulting in successful pulmonary reperfusion. After a prolonged in-hospital stay, the patient was discharged in stable condition.
KW - cardiac arrest
KW - ECMO
KW - extracorporeal life-support
KW - high-risk pulmonary embolism
KW - thrombolysis
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U2 - 10.3389/fcvm.2024.1444636
DO - 10.3389/fcvm.2024.1444636
M3 - Article
AN - SCOPUS:85200221918
SN - 2297-055X
VL - 11
JO - Frontiers in cardiovascular medicine
JF - Frontiers in cardiovascular medicine
M1 - 1444636
ER -