Intracranial hemorrhage in a patient with sub-massive pulmonary embolism treated with EkoSonic endovascular system directed thrombolysis.
Ultrasound-assisted catheter-directed thrombolysis therapy has emerged more recently as a management strategy for patients with intermediate risk pulmonary embolism and has shown promising results in clinical trials by early reversal of right ventricle dilation, reduced pulmonary hypertension, and decreased anatomic thrombus burden. This therapeutic strategy requires a small fraction of the systemic fibrinolytic dose and is therefore associated with a reduced bleeding risk. Although intracranial hemorrhage has not been reported in clinical trials, it is a possible complication. Here we report the first case of intracranial hemorrhage related to the use of EkoSonic™ Endovascular System directed thrombolysis in a patient with large bilateral pulmonary embolism without any identifiable bleeding risks. © 2017 Wiley Periodicals, Inc.
['Ganatra|Sarju|S|http://orcid.org/0000-0003-0296-6864', 'Majithia|Arjun|A|', 'Yeh|Yun-Ting Eric|YE|', 'Levy|Michael S|MS|']
D000369:Aged, 80 and over D000072226:Computed Tomography Angiography D004452:Echocardiography D057510:Endovascular Procedures D004867:Equipment Design D017809:Fatal Outcome D005260:Female D005343:Fibrinolytic Agents D006801:Humans D020300:Intracranial Hemorrhages D011655:Pulmonary Embolism D012307:Risk Factors D015912:Thrombolytic Therapy D010959:Tissue Plasminogen Activator D016896:Treatment Outcome D018084:Ultrasonography, Interventional D062666:Vascular Access Devices
intracranial hemorrhage pulmonary embolism EkoSonic endovascular system ultrasound-assisted catheter-directed thrombolysis EKOS