Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism

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.