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Article

Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up

by
Jesús Ribas
1,2,3,*,
Joana Valcárcel
2,4,
Esther Alba
2,4,
Yolanda Ruíz
1,2,
Daniel Cuartero
2,5,
Adriana Iriarte
2,5,
José María Mora-Luján
2,5,
Marta Huguet
2,6,
Pau Cerdà
2,5,
Sergio Martínez-Yélamos
2,7,8,
Xavier Corbella
2,5,9,
Salud Santos
1,2,3,8 and
Antoni Riera-Mestre
2,5,8
1
Pneumology Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
2
Bellvitge Biomedical Research Institute (IDIBELL), 08907 Barcelona, Spain
3
Biomedical Research Networking Center on Respiratory Diseases (CIBERES), 28029 Madrid, Spain
4
Radiology Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
5
Internal Medicine Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
6
Critical Care Medicine Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
7
Neurology Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
8
Faculty of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
9
Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(20), 4716; https://doi.org/10.3390/jcm10204716
Submission received: 6 September 2021 / Revised: 11 October 2021 / Accepted: 12 October 2021 / Published: 14 October 2021
(This article belongs to the Section Respiratory Medicine)
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Abstract

(1) Background: Catheter-directed therapies (CDT) may be considered for selected patients with pulmonary embolism (PE); (2) Methods: Retrospective observational study including all consecutive patients with acute PE undergoing CDT (mechanical or pharmacomechanical) from January 2010 through December 2020. The aim was to evaluate in-hospital and long-term mortality and its predictive factors; (3) Results: We included 63 patients, 43 (68.3%) with high-risk PE. All patients underwent mechanical CDT and, additionally, 27 (43%) underwent catheter-directed thrombolysis. Twelve (19%) patients received failed systemic thrombolysis (ST) prior to CDT, and an inferior vena cava (IVC) filter was inserted in 28 (44.5%) patients. In-hospital PE-related and all-cause mortality rates were 31.7%; 95% CI 20.6–44.7% and 42.9%; 95% CI 30.5–56%, respectively. In multivariate analysis, age > 70 years and previous ST were strongly associated with PE-related and all-cause mortality, while IVC filter insertion during the CDT was associated with lower mortality rates. After a median follow-up of 40 (12–60) months, 11 more patients died (mortality rate of 60.3%; 95% CI 47.2–72.4%). Long-term survival was significantly higher in patients who received an IVC filter; (4) Conclusions: Age > 70 years and failure of previous ST were associated with mortality in acute PE patients treated with CDT. In-hospital and long-term mortality were lower in patients who received IVC filter insertion.
Keywords: endovascular procedures; mortality; pulmonary embolism; thrombectomy; thrombolytic therapy; vena cava filters endovascular procedures; mortality; pulmonary embolism; thrombectomy; thrombolytic therapy; vena cava filters

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MDPI and ACS Style

Ribas, J.; Valcárcel, J.; Alba, E.; Ruíz, Y.; Cuartero, D.; Iriarte, A.; Mora-Luján, J.M.; Huguet, M.; Cerdà, P.; Martínez-Yélamos, S.; et al. Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up. J. Clin. Med. 2021, 10, 4716. https://doi.org/10.3390/jcm10204716

AMA Style

Ribas J, Valcárcel J, Alba E, Ruíz Y, Cuartero D, Iriarte A, Mora-Luján JM, Huguet M, Cerdà P, Martínez-Yélamos S, et al. Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up. Journal of Clinical Medicine. 2021; 10(20):4716. https://doi.org/10.3390/jcm10204716

Chicago/Turabian Style

Ribas, Jesús, Joana Valcárcel, Esther Alba, Yolanda Ruíz, Daniel Cuartero, Adriana Iriarte, José María Mora-Luján, Marta Huguet, Pau Cerdà, Sergio Martínez-Yélamos, and et al. 2021. "Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up" Journal of Clinical Medicine 10, no. 20: 4716. https://doi.org/10.3390/jcm10204716

APA Style

Ribas, J., Valcárcel, J., Alba, E., Ruíz, Y., Cuartero, D., Iriarte, A., Mora-Luján, J. M., Huguet, M., Cerdà, P., Martínez-Yélamos, S., Corbella, X., Santos, S., & Riera-Mestre, A. (2021). Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up. Journal of Clinical Medicine, 10(20), 4716. https://doi.org/10.3390/jcm10204716

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