Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism
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摘要: 肺血栓栓塞症(pulmonary thromboembolism,PTE)是心血管疾病中导致患者死亡的第三大常见原因。在真实世界中,因担心出现大出血等风险,仅20%~30%的高危PTE患者接受了系统性溶栓治疗,虽然中危PTE患者接受系统性溶栓可降低死亡率,但出血风险远高于获益。超声辅助导管溶栓可在血栓部位直接释放溶栓药物,所需药物剂量更低,且超声波可促进血栓溶解,有望成为一种安全、有效的溶栓新手段。本文将介绍超声辅助导管溶栓的机制、所需设备与操作程序、安全性与有效性等,并对未来的研究方向提出展望。Abstract: Pulmonary thromboembolism(PTE)is the third most common cause of cardiovascular death. However, only about 20% to 30% of patients with high-risk PTE received systemic thrombolysis in real world, due to concerns about the risks such as major bleeding. Although systemic thrombolysis could decrease all-cause mortality of patients with intermediate-risk PTE, the risk of bleeding outweighs the benefits. Ultrasound-assisted catheter-directed thrombolysis (UA-CDT) could directly deliver thrombolytic drugs to the thrombus with lower doses needed. Meanwhile, ultrasound waves could also enhance thrombolysis. Therefore, UA-CDT is emerging as a new tool, with good efficacy and safety records, for the treatment of PTE. In the present review article, we introduce the mechanism, required device, common protocol, efficacy and safety of UA-CDT and discuss directions for future studies.
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Key words:
- pulmonary thromboembolism /
- thrombolytic therapy /
- ultrasound wave
作者贡献:柳志红、罗勤负责构思论文;罗勤、赵智慧、赵青、张毅负责查阅文献资料;张毅负责撰写论文;柳志红、罗勤、赵智慧、赵青、张毅负责修订论文。利益冲突:所有作者均声明不存在利益冲突 -
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