CATHETER DIRECTED THROMBOLYSIS FOR PULMONARY THROMBOEMBOLISM (PTE)
What is pulmonary thromboembolism (PTE):
- Pulmonary thromboembolism is a disease in which blood vessel of lung is blocked by blood clot. Most commonly it occurs in patients having deep vein thrombosis (vessel blockage) in legs.
What are the symptoms:
- It causes increase in heart rate, difficulty in breathing, chest pain and haemoptysis (bloody cough). It may lead to death if it involves large vessel of lung.
How it can be treated:
- It can be treated with medicine or with catheter directed thrombolysis/thrombectomy depending upon clot burden & its location.
- Large clot burden should be treated with catheter-directed pulmonary thrombolysis/ thrombectomy. It treats vascular blockages and improves blood flow of pulmonary circulation by dissolving/removing abnormal blood clots.
- It involves small pinhole in leg vein through which image-guided thrombolysis/thrombectomy performed by a specially trained interventional radiologist in cath lab suite.
- In thrombolysis, the catheter is left in place and connected to a special machine that delivers the medication at a precise rate over several hours to a few days. It may take up to 72 hours for the clot to dissolve (although most clots dissolve within 24 hours), during which time patient will be monitored closely by the medical staff.
- In thrombectomy, the special aspiration catheter and aspiration pump is used for aspiration of blood clot. It opens blocked vessels instantly if clot is recent.
What are benefits of this procedure:
- Catheter-directed thrombolysis/thrombectomy can greatly improve blood flow and reduce or eliminate the related symptoms and effects without the need for more invasive surgery.
- It is a safe, highly effective way of re-establishing circulation blocked by a clot.
- Blood loss is less than with traditional surgical treatment and there is no obvious surgical incision so hospital stay is less.
Preparation for procedure:
- Few basic blood investigations like CBC, PT/INR, viral markers.
- Bring all the records including imaging record.
- Signing consent form.
What are risks:
- Very few, includes bleeding, arrhythmia, vessel wall injury(<1 case in 1000).
