Successful pharmaco-invasive approach using a lower alteplase dose and VA-ECMO support in high-risk pulmonary embolism: case report

Paola Gutierrez-Gallegos, Vicente Jimenez-Franco, Carlos Jerjes-Sanchez, Renata Quevedo-Salazar, Jahir Rodriguez-Rivera, Enrique Paredes-Gutierrez, Daniel Lira-Lozano, Juan Quintanilla-Gutierrez, Rene Gomez-Gutierrez, Erasmo de la Peña-Almaguer, Guillermo Torre-Amione

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article number1444636
JournalFrontiers in cardiovascular medicine
Volume11
DOIs
StatePublished - 2024

Keywords

  • cardiac arrest
  • ECMO
  • extracorporeal life-support
  • high-risk pulmonary embolism
  • thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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