Comparison of outcomes and complications in conventional versus ultrasound-accelerated catheter directed thrombolysis for treatment of pulmonary embolism: A systematic review and meta-analysis-Reference-Cited by-同舟云学术

Comparison of outcomes and complications in conventional versus ultrasound-accelerated catheter directed thrombolysis for treatment of pulmonary embolism: A systematic review and meta-analysis

Published:2022-06-20 Issue: Volume: Page:026765912211088
ISSN:0267-6591
Container-title:Perfusion
language:en
Short-container-title:Perfusion

Author:

Farrokhi Mehrdad¹^ORCID,Khurshid Maria²,Yarmohammadi Bardia³,Mangouri Amir⁴,Alipour-Khabir Yalda⁵,Alipour-Khabir Sevda⁵,Sargazi Moghadam Nasibeh⁶,Mosalanejad Shima⁷,Nourizadeh Sama⁵,Jafari Sina⁸,Amani-Beni Reza⁹,Hosseini-Saryazdi Seyyed-Mohammad⁹,Zarei Shiva¹⁰^ORCID,Sanjarian Sahar¹¹,Babasafari Hesam‐aldin¹²,Shakori Poshteh Shiva¹³,Masoudi Negar¹⁴,Zahedpasha Reza¹⁵^ORCID,Kiani Moein¹⁶,Jalalifar Fatemeh¹⁷,Taheri Fatemeh¹⁸

Affiliation:

1. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2. Department of Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA

3. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4. Department of Vascular and Endovascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

5. School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran

6. Graduated, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

7. Department of Internal Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

8. Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran

9. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10. Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

11. Lamerd Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

12. Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

13. School of Pharmacy, Sydney University, Sydney, NSW, Australia

14. Department of Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

15. School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran

16. School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

17. School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran

18. Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

Abstract

Background Acute submassive a massive pulmonary embolism are known as leading causes of cardiovascular morbidity and mortality in emergency departments. Choosing the optimal type of catheter directed thrombolysis (CDT) for treatment of pulmonary embolism presents a quandary to the practitioners. To the best of our knowledge, there is no meta-analysis comparing superiority of conventional CDT and ultrasound-accelerated catheter directed thrombolysis (USACDT). Therefore, in this meta-analysis, we aimed to compare conventional CDT with USACDT regarding clinical outcomes and safety profile. Methods A systematic literature search of previous published studies comparing conventional CDT with USACDT regarding clinical outcomes and safety profile was carried out in the electronic databases including MEDLINE, Scopus, EBSCO, Google Scholar, Web of Science, and Cochrane from inception to December 2021. Data were analyzed by comprehensive meta-analysis software (CMA, version 3). Results The meta-analysis included nine studies with a total of 705 patients. Our meta-analysis showed that there is no significant difference between two groups with respect to pulmonary arterial systolic pressure (SMD: −0.084; 95% CI: −0.287 to 0.12; p: 0.41), RV/LV (SMD: −0.003; 95% CI: −0.277 to 0.270; p: 0.98), and Miller score (SMD: −0.345; 95% CI: −1.376 to 0.686; p: 0.51). Similarly, we found no statistically significant differences between two groups regarding major and minor bleeding ( p > .05). Conclusion Our meta-analysis showed that when compared with USACDT, conventional CDT provides similar clinical and hemodynamic outcomes or safety for treatment of pulmonary embolism without the need for very expensive technologies. However, randomized clinical trials are required to further investigate cost-effectiveness of USACDT in comparison with conventional CDT.

Publisher

SAGE Publications

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Safety Research,Radiology, Nuclear Medicine and imaging,General Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/02676591221108811

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