3:45 PM Abstract No. 260 Survival analysis outcomes of catheter-directed therapy of submassive pulmonary embolism

Abstract

The implementation of catheter-directed treatment (CDT) of submassive pulmonary embolus (PE) including mechanical aspiration thrombectomy and/or ultrasound-assisted thrombolysis requires analysis of outcomes regarding mortality and survival analysis. The purpose of this study was to perform a survival analysis on submassive patients treated with CDT and compare the analysis to a matched cohort on patients treated with anticoagulation. A retrospective study approved by the institutional review board to investigate patient outcomes of catheter-based therapies of submassive PEs in comparison to patients treated solely with anticoagulation was performed. Data was tracked over three years and used to perform survival analysis and create Kaplan-Meier curves using R Studio. Over three years, our analysis included 93 submassive patients. There were 36 treated with CDT plus anticoagulation and 57 patients treated with anticoagulation alone. Overall, both groups demonstrated relatively high survival rates over the course of three years. The CDT group survival probability decreased to 82% over three years, while the survival probability of the anticoagulation group decreased to 88%. Both shared a >90% higher survival probability in the first 100 days, then dropping to <90% after 100 days. A long rank test demonstrated no statistically significance regarding survival probability (P = 0.41) Previous conventional thought was that catheter intervention improves outcomes closer to treatment; however, our analysis demonstrates similar survival probabilities over three years. Further investigation is prompted given our small sample size. A more developed Kaplan-Meier curve may be formed as patients are followed for 5-10 years, allowing as well for more accurate survival analysis. Given the study involved submassive patients, the impact of CDT may not be in survival analysis but may be in the changes in quality of life and prevention of right heart dysfunction.