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Comparison of Outcomes and Complications in Conventional Versus Ultrasound-Accelerated Catheter Directed Thrombolysis for Treatment of Pulmonary Embolism: A Systematic Review and Meta-Analysis Publisher Pubmed



Farrokhi M1 ; Khurshid M2 ; Yarmohammadi B3 ; Mangouri A4 ; Alipourkhabir Y5 ; Alipourkhabir S5 ; Sargazi Moghadam N6 ; Mosalanejad S7 ; Nourizadeh S5 ; Jafari S8 ; Amanibeni R9 ; Hosseinisaryazdi SM9 ; Zarei S10 ; Sanjarian S11 Show All Authors
Authors
  1. Farrokhi M1
  2. Khurshid M2
  3. Yarmohammadi B3
  4. Mangouri A4
  5. Alipourkhabir Y5
  6. Alipourkhabir S5
  7. Sargazi Moghadam N6
  8. Mosalanejad S7
  9. Nourizadeh S5
  10. Jafari S8
  11. Amanibeni R9
  12. Hosseinisaryazdi SM9
  13. Zarei S10
  14. Sanjarian S11
  15. Babasafari H12
  16. Shakori Poshteh S13
  17. Masoudi N14
  18. Zahedpasha R15
  19. Kiani M16
  20. Jalalifar F17
  21. Taheri F18
Show Affiliations
Authors Affiliations
  1. 1. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Internal Medicine, Berkshire Medical Center, Pittsfield, MA, United States
  3. 3. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department of Vascular and Endovascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
  6. 6. Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. Department of Internal Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
  8. 8. Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
  9. 9. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  10. 10. Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
  11. 11. Lamerd Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
  12. 12. Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
  13. 13. School of Pharmacy, Sydney University, Sydney, NSW, Australia
  14. 14. Department of Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
  15. 15. School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
  16. 16. School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  17. 17. School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
  18. 18. Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

Source: Perfusion (United Kingdom) Published:2023


Abstract

Background: Acute submassive a massive pulmonary embolism are known as leading causes of cardiovascular morbidity and mortality in emergency departments. Choosing the optimal type of catheter directed thrombolysis (CDT) for treatment of pulmonary embolism presents a quandary to the practitioners. To the best of our knowledge, there is no meta-analysis comparing superiority of conventional CDT and ultrasound-accelerated catheter directed thrombolysis (USACDT). Therefore, in this meta-analysis, we aimed to compare conventional CDT with USACDT regarding clinical outcomes and safety profile. Methods: A systematic literature search of previous published studies comparing conventional CDT with USACDT regarding clinical outcomes and safety profile was carried out in the electronic databases including MEDLINE, Scopus, EBSCO, Google Scholar, Web of Science, and Cochrane from inception to December 2021. Data were analyzed by comprehensive meta-analysis software (CMA, version 3). Results: The meta-analysis included nine studies with a total of 705 patients. Our meta-analysis showed that there is no significant difference between two groups with respect to pulmonary arterial systolic pressure (SMD: −0.084; 95% CI: −0.287 to 0.12; p: 0.41), RV/LV (SMD: −0.003; 95% CI: −0.277 to 0.270; p: 0.98), and Miller score (SMD: −0.345; 95% CI: −1.376 to 0.686; p: 0.51). Similarly, we found no statistically significant differences between two groups regarding major and minor bleeding (p >.05). Conclusion: Our meta-analysis showed that when compared with USACDT, conventional CDT provides similar clinical and hemodynamic outcomes or safety for treatment of pulmonary embolism without the need for very expensive technologies. However, randomized clinical trials are required to further investigate cost-effectiveness of USACDT in comparison with conventional CDT. © The Author(s) 2022.
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