4:12 PM Abstract No. 229 The thromboaspiration with INDIGO system reduces the time and dose of fibrinolysis and improves the results in massive pulmonary embolism in comparison with catheter fragmentation (previous cohort study)

Abstract

Determine if thromboaspiration with indigo system improves short- and medium-term outcomes compared with interventional treatment of choice for pulmonary embolism (PE) (mechanical thrombolysis + catheter-directed thrombolytic therapy). From Apr-2016 to Aug-2017, 43 patients diagnosed massive PE and a comparative with previous study of 111 patients with massive PE. In the first cohort all patients were treated with thromboaspiration + catheter-directed thrombolytic therapy (TAs) and the other cohort were treated with conventionally according to our protocol: thrombolysis + catheter fragmentation (MFT). There were no significant differences in age, sex and the angiographic pulmonary index (Miller index). Pulmonary pressures after fibrinolysis and one month later were compared. The total dose and the total time of fibrinolysis were also compared in both groups. Postoperative mean pulmonary arterial pressure (PAPm) was 34.06 ± 5.81 mm Hg TAs and 39.46 ± 6.39 mm Hg MFT, without showing significant differences in both groups regarding the 24hours and after 1- month angiographic control. There were significant differences in the total dose administered of urokinase (UK) (1.38 ± 0.25 IU of UK TAs MFT vs 2.82 ± 0.89 million IU of UK MFT) and the total time of UK perfusion (13.05 ± 1.70 hours TAs vs. 21.69 ± 11.92 hours MFT). four patients (9.3%) died in the follow-up in the cohort TAs with only 1 (2.3%) related to PE vs. 7 patients (6.3%) with only 4 (3.6%) related to PE or complications of endovascular treatment MFT. Thromboaspiration improves the results of conventional mechanical fragmentation and catheter-directed thrombolytic therapy, decreasing the time and total dosage of fibrinolysis and also decreasing PAP more rapidly.