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Catheter-directed Therapy Should Be Considered a First-line Treatment Option for Massive Blood Clots in the Lungs, According to Study of Nearly 600 Patients in Interventional Radiology.

Catheter-directed therapy or catheter-directed thrombolysis--an interventional radiology treatment that uses targeted image-guided drug delivery with specially designed catheters to dissolve dangerous blood clots in the lungs--saves lives and should be considered a first-line treatment option for massive pulmonary embolism, note researchers in the November Journal of Vascular and Interventional Radiology.

Pulmonary embolism occurs when one or more arteries in the lungs become blocked from blood clots that break free and travel there. These clots most often begin as deep vein thrombosis (DVT) or blood clots within the deep leg veins. When the clots break free, circulate and become trapped in the lungs, they can block the oxygen supply, cause heart failure and result in death. About 600,000 cases of acute pulmonary embolism are diagnosed each year in the United States, and an estimated 300,000 patients die, noted Kuo. "If initiated early, minimally invasive catheter-directed therapy could save many of those lives," added the lead author of the study, "Catheter-directed Therapy for the Treatment of Massive Pulmonary Embolism: Systematic Review and Meta-analysis of Modern Techniques."

During the treatment, an interventional radiologist inserts specially designed catheters (thin plastic tubes) through a tiny incision into one's blood vessels and guides the catheters using real-time imaging without traditional open surgery. This allows an interventional radiologist to deliver a clot-busting medicine directly into the clot. The catheters may also be used to mechanically break up clots and suction them away. This treatment offers less pain and less recovery time than traditional open surgery, said Kuo.

Stanford University researchers conducted a meta-analysis of the treatment on 594 patients in 18 countries who were treated between 1990 and 2008. The treatment was lifesaving in 86.5 percent of the cases studied and had only a 2.4 percent chance of major complications. Researchers found that not only was the treatment effective, but it also appeared much safer than the historical complication rates reported from injecting high-dose clot-busting medicine systemically or directly into the blood stream where the drug can circulate throughout the body and cause major bleeding in up to 20 percent of patients.

Source:  SIR

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