Title:Catheter-directed Thrombolysis versus Systemic Anticoagulation for Submassive
Pulmonary Embolism: A Meta-Analysis
Volume: 18
Issue: 1
Author(s): Juan Arturo Siordia*Amanpreet Kaur
Affiliation:
- Department of Internal Medicine, Banner-University Medical Center - South Campus, 2800 E Ajo Way, Tucson, AZ
85713, United States
Keywords:
Submassive pulmonary embolism, catheter-directed thrombolysis, systematic anticoagulation, thrombolytic, heparin, hemodynamic instability.
Abstract:
Background: The optimal therapy for submassive pulmonary embolism remains in question.
The following meta-analysis compiles the current evidence comparing Catheter-Directed
Thrombolysis (CDT) versus Systemic Anticoagulation (SA).
Methods: An electronic search through PubMed and Google scholar revealed studies comparing
CDT versus SA in terms of mortality and major bleeding events. Thirty-day, 90-day, and one-year
mortality results were analyzed.
Results: Six studies were included in the meta-analysis. Thirty-day and one-year mortality were
less with CDT compared to SA (OR 0.27 [CI 0.11-0.67]; and OR 0.50 [CI 0.28-0.89]). Ninety-day
mortality was similar between the two methods (OR 0.57 [CI 0.17-1.92]). Compilation of all
studies reporting at least greater than 30-day mortality revealed less mortality with CDT (OR 0.51
[0.30-0.86]). Major bleeding was similar between the two treatments (OR 1.63 [CI 0.63-4.20]).
Conclusion: CDT has less 30-day and 1-year mortality with equivalent rates of major bleeding
compared to SA for treatment of submassive pulmonary embolism.
