In Reply to: Case 1001-07 -- Pulmonary Artery Thrombectomy and Thrombolysis posted by Editor on October 04, 2001 at 12:04:43:
I have to believe that you did this patient good.
Even though the literature does not support
infusion of thrombolytics into the main PAs, I
am not aware of any studies looking at
intra-thrombus catheter-directed lysis. If the
lungs behave like other parts of the body,
catheter-directed has got to be better. We
have used suction thrombectomy with guide
catheters, Possis AngioJet, and Hydrolyzer.
All are imperfect, and the AngioJet can cause
an unusual effect of extreme pain and panic.
Maceration alone is controversial, but it
increases the surface area amenable to lysis.
We have had one complication - massive
hemoptysis about 30 minutes after the
procedure, that resulted in the 4th of 5 arrests
that patient had that day. There was no 6th.