Question
A 65-year-old female is hospitalized for a massive pulmonary embolism. She was treated with catheter-directed thrombolysis (CDT). Which of the following is the most common complication of CDT?
| A. |
Hemorrhagic stroke
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| B. |
Cardiac tamponade
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| C. |
Retroperitoneal bleed
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| D. |
Renal failure
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Show Answer
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Correct Answer � A
Explanation
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Ans. A
There are several possible complications of CDT for pulmonary embolism. One of the most common and most feared complications being hemorrhagic stroke which can be debilitating. However, catheter-directed thrombolysis has a lower risk of hemorrhage than systemic thrombolysis.
Other common complications include vascular access-related injury, pulmonary hemorrhage, retroperitoneal hemorrhage, cardiogenic shock, perforation or dissection of the pulmonary artery, arrhythmias, right-sided valvular regurgitation, pericardial tamponade, and contrast-induced nephropathy.
CDT with ultrasonic therapy aids in the delivery of thrombolysis into the tissue. The CDT catheter is threaded up through the right heart into the pulmonary vasculature to the site of the embolus. The guide-wire must be passed past the site of PE to properly perform the procedure.
CDT is an alternative revascularization procedure (as opposed to systemic thrombolysis and surgical embolectomy). Despite the above-stated risks, it has been shown to reduce the systemic risk of thrombolytic therapy and improve morbidity and mortality for a patient with pulmonary embolism.
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