Treatment of Pulmonary Embolism: a Decade of Experience

A. Nikonenko; A. Nikonenko; S. Matvieiev; V. Osaulenko; S. Nakonechniy

doi:10.30702/ujcvs/19.3505/038046-049

A. Nikonenko Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine, Zaporizhzhia, Ukraine; Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
A. Nikonenko Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
S. Matvieiev Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine; Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine
V. Osaulenko Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine, Zaporizhzhia, Ukraine; Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine
S. Nakonechniy Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine, Zaporizhzhia, Ukraine; Zaporizhzhia Regional Clinical Hospital, Zaporizhzhia, Ukraine

DOI: https://doi.org/10.30702/ujcvs/19.3505/038046-049

Keywords: pulmonary embolism, computer tomography, anticoagulants, thrombolysis, recurrent pulmonary embolism

Abstract

Pulmonary embolism (PE) is a major life-threatening illness which remains one of the main causes of sudden death throughout the world. The analysis of diagnosis and treatment of 472 patients with acute pulmonary embolism for a period of 10 years was performed. High efficiency of diagnosis using multispiral computer angiopulmonography (MSCT APG) has been established, thus this method completely supersedes the traditional selective angiopulmonography.

Seventeen (3.6 %) patients died due to PE recurrence, another 8 (1.7 %) patients died due to the bleeding after using fibrinolytics and anticoagulants, and 14 (2.9 %) died due to progression of organs failure. This emphasizes the need to improve measures aimed to prevent PE recurrence and identify sources of possible bleeding and refrain from aggressive fibrinolytic therapy.

The use of differentiated approach to the treatment with thrombolytic therapy and anticoagulants enabled to achieve recovery in 433 (91.7 %) patients who were discharged for outpatient treatment. New oral anticoagulants were prescribed to 94 (21.7 %) patients after discharge.

References

Konstantinides SV, Barco S, Lankeit M, Meyer G. Management of Pulmonary Embolism: An Update. J Am Coll Cardiol. 2016 Mar 1;67(8):976–90. https://doi.org/10.1016/j.jacc.2015.11.061
Raskob GE, Angchaisuksiri P, Blanco AN, Buller H, Gallus A, Hunt BJ, et al. Thrombosis: a major contributor to global disease burden. Arterioscler Thromb Vasc Biol. 2014 Nov;34(11):2363–71. https://doi.org/10.1161/ATVBAHA.114.304488
Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiи N, et. al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). European Heart Journal. 2014;35(43):3033–73.
Rudik MV, Rudik IV. Pulmonary embolism by foreign bodies: a case report. Zaporozhye medical journal. 2018;20(6):873–876. Russian.
Leibfried M, Falbaum S, Palummo J, Dickinson F. Treatment of Pulmonary Embolism. US Pharm. 2018;43(7): HS2–HS12.