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Catheter-Directed Therapy: Outcomes vs Standard of Care and Evaluation of Current Practice.

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Citation: American Journal of Medicine. 134(3):400-404, 2021 03.PMID: 33144134Institution: MedStar Good Samaritan Hospital | MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Catheterization | *Pulmonary Embolism/th [Therapy] | *Standard of Care | *Thrombolytic Therapy/mt [Methods] | *Tissue Plasminogen Activator/ad [Administration & Dosage] | *Vena Cava Filters | Aged | Female | Hospital Mortality | Humans | Male | Middle Aged | Pulmonary Embolism/mo [Mortality] | Retrospective Studies | Treatment OutcomeYear: 2021 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - presentISSN:

0002-9343

Name of journal: The American journal of medicineAbstract: BACKGROUND: Small studies have noted benefit with use of catheter-directed therapy (CDT) versus standard of care in treatment of pulmonary embolism, but none have focused on the variability of clinical practice with this modality.CONCLUSIONS: In this study, no significant difference in inpatient mortality or major bleeding was found in ICU pulmonary embolism patients who underwent CDT compared with standard care. It may be beneficial to standardize this procedure, given the potential benefit of CDT in patients with submassive pulmonary embolism. Copyright (c) 2020. Published by Elsevier Inc.METHODS: ICD codes were used to retrospectively identify consecutive adult patients admitted to an intensive care unit (ICU) with pulmonary embolism over a 2-year period. We evaluated inpatient mortality and major bleeding and assessed treatment variation.RESULTS: Of 284 patients included, 46 underwent CDT (9 massive pulmonary embolism, 37 submassive pulmonary embolism). Significantly more patients who underwent standard treatment had a history of congestive heart failure and diabetes. Obesity, higher troponin levels, and right heart strain were significantly more likely in the CDT group. No significant difference in inpatient mortality or major bleeding events was observed between the treatment groups. Tissue plasminogen activator use varied widely in the CDT group, and inferior vena cava filter utilization was significantly more common in the CDT group (18; 41%) compared to the standard group (40; 17%) (p <0.01).All authors: Camire L, Hernandez J, Kalaria A, Saleh N, Weisman DS, Zulty MOriginally published: American Journal of Medicine. 2020 Oct 31Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1016/j.amjmed.2020.09.045

Date added to catalog: 2020-12-29

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33144134	Available		33144134

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present

BACKGROUND: Small studies have noted benefit with use of catheter-directed therapy (CDT) versus standard of care in treatment of pulmonary embolism, but none have focused on the variability of clinical practice with this modality.

CONCLUSIONS: In this study, no significant difference in inpatient mortality or major bleeding was found in ICU pulmonary embolism patients who underwent CDT compared with standard care. It may be beneficial to standardize this procedure, given the potential benefit of CDT in patients with submassive pulmonary embolism. Copyright (c) 2020. Published by Elsevier Inc.

METHODS: ICD codes were used to retrospectively identify consecutive adult patients admitted to an intensive care unit (ICU) with pulmonary embolism over a 2-year period. We evaluated inpatient mortality and major bleeding and assessed treatment variation.

RESULTS: Of 284 patients included, 46 underwent CDT (9 massive pulmonary embolism, 37 submassive pulmonary embolism). Significantly more patients who underwent standard treatment had a history of congestive heart failure and diabetes. Obesity, higher troponin levels, and right heart strain were significantly more likely in the CDT group. No significant difference in inpatient mortality or major bleeding events was observed between the treatment groups. Tissue plasminogen activator use varied widely in the CDT group, and inferior vena cava filter utilization was significantly more common in the CDT group (18; 41%) compared to the standard group (40; 17%) (p <0.01).

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