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Ekos pulmonary embolism

Alana James, Satyam Veean, Jayanth H Keshavamurthy, Gyanendra Sharma
A 69-year old bed-bound woman presented with chest pain and diaphoresis. Diagnostic imaging led to the diagnosis of bilateral extensive pulmonary emboli extending into all segmental branches. Tissue plasminogen activator (tPA) was administered via 2 separate EKOS catheters. Repeat evaluation after 33 hours revealed improvement of right ventricular size and function. EKOS catheters are useful for administration of fibrinolytics in pulmonary embolism.
May 2017: Lung India: Official Organ of Indian Chest Society
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
Immad Sadiq, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure...
February 2017: Vascular Medicine
Timothy J Fuller, Christopher M Paprzycki, Muhammad H Zubair, Lala R Hussain, Brian A Kuhn, Matthew H Recht, Patrick E Muck
BACKGROUND: Interventional strategies for massive and submassive pulmonary embolism (smPE) have historically included either systematic intravenous thrombolytic alteplase or surgical embolectomy, both of which are associated with significant morbidity and mortality. However, with the advent of endovascular techniques, recent studies have suggested that an endovascular approach to the treatment of acute smPE may be both safe and effective with excellent outcomes. The purpose of this study was to evaluate the outcomes of patients who have undergone catheter-directed thrombolysis (CDT) for smPE at our institution in an effort to determine the safety of the procedure...
January 2017: Annals of Vascular Surgery
Saim Sag, Omer Fatih Nas, Aysel Aydin Kaderli, Bulent Ozdemir, İbrahim Baran, Cuneyt Erdoğan, Sumeyye Gullulu, Bahattin Hakyemez, Ali Aydinlar
The treatment options for high risk acute pulmonary embolism (PE) patients with failed systemic thrombolytic treatment (STT) is limited. The clinical use of catheter directed thrombolysis with the EkoSonic Endovascular System (EKOS) in this population has not been evaluated before. Catheter directed thrombolysis is an effective treatment modality for high risk PE patients with failed STT. Thirteen consecutive patients with failed STT were included in the study. EKOS catheters were placed and tissue plasminogen activator (t-PA) in combination with unfractionated heparin were given...
October 2016: Journal of Thrombosis and Thrombolysis
Madeline Nykamp, Angela VandenHull, Tyler Remund, Angelo Santos, Patrick Kelly, Greg Schultz, Chad Laurich
OBJECTIVE: The objective of this study was to evaluate the safety and effectiveness of ultrasound-accelerated thrombolysis in acute pulmonary embolism. METHODS: A retrospective study of 45 patients was performed to evaluate treatment of acute pulmonary embolism at a single center from January 2011 to December 2013. All patients were diagnosed with computed tomography or ventilation-perfusion scan and had hemodynamic instability (systolic blood pressure <100 mm Hg) or right-sided heart strain evidenced by right ventricular dilation, septal deviation, or hypokinesis by echocardiography or computed tomography...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Ajay Yadlapati, Ranya Sweis, Daniel Schimmel
We describe a case series of 3 patients presenting with intracardiac thrombi treated with standard anticoagulation therapy and intervention with ultrasound-accelerated thrombolysis therapy. Right-sided intracardiac thrombi portend significant mortality due to their susceptibility for embolization and pulmonary embolus despite the continuation of current standard of therapy of parenteral anticoagulation and surgical embolectomy if warranted. We demonstrate the safety and clinical efficacy of ultrasound-accelerated thrombolysis therapy with the EkoSonic Endovascular System infusion catheter system (EKOS Corporation) and highlight its use in resolving intracardiac thrombi and impeding the propagation of pulmonary emboli...
March 2016: Journal of Invasive Cardiology
Gregory Piazza, Benjamin Hohlfelder, Michael R Jaff, Kenneth Ouriel, Tod C Engelhardt, Keith M Sterling, Noah J Jones, John C Gurley, Rohit Bhatheja, Robert J Kennedy, Nilesh Goswami, Kannan Natarajan, John Rundback, Immad R Sadiq, Stephen K Liu, Narinder Bhalla, M Laiq Raja, Barry S Weinstock, Jacob Cynamon, Fakhir F Elmasri, Mark J Garcia, Mark Kumar, Juan Ayerdi, Peter Soukas, William Kuo, Ping-Yu Liu, Samuel Z Goldhaber
OBJECTIVES: This study conducted a prospective, single-arm, multicenter trial to evaluate the safety and efficacy of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis, using the EkoSonic Endovascular System (EKOS, Bothell, Washington). BACKGROUND: Systemic fibrinolysis for acute pulmonary embolism (PE) reduces cardiovascular collapse but causes hemorrhagic stroke at a rate exceeding 2%. METHODS: Eligible patients had a proximal PE and a right ventricular (RV)-to-left ventricular (LV) diameter ratio ≥0...
August 24, 2015: JACC. Cardiovascular Interventions
James M McCabe, Pei-Hsiu Huang, Lauren Riedl, Andrew C Eisenhauer, Piotr Sobieszczyk
The optimal treatment for intermediate-risk pulmonary embolism (PE) remains unclear. Our goal was to describe the safety and efficacy of the EkoSonic ultrasound-assisted catheter-directed thrombolysis system (EKOS Corporation, Bothell, Washington) in a real-world registry of patients with intermediate-risk PE. Fifty-three consecutive patients with intermediate-risk PE treated with ultrasound-assisted catheter-directed thrombolysis at Brigham and Women's Hospital from 2010 to 2014 were analyzed. The primary outcome was a change in directly measured pulmonary artery pressures as assessed using logistic regression with generalized estimating equations to account for serial measurements...
March 15, 2015: American Journal of Cardiology
N W Shammas, R Padaria, G Ahuja
OBJECTIVE: Right atrial thrombus in the setting of a large pulmonary embolus is rare and is associated with serious adverse events. This case report presents the role played by EKOS EkoSonic ultrasound system in successfully treating right atrial thrombus and massive pulmonary embolism. CASE REPORT: A 69-year-old female presented with a massive pulmonary embolus and a large mobile right atrial thrombus. She was treated with catheter-directed lysis using the EKOS EkoSonic ultrasound system and tissue plasminogen activator, with complete resolution of her right atrial thrombus and a marked improvement in her pulmonary embolus and hemodynamics...
December 2015: Phlebology
Mert Dumantepe, Ibrahim Uyar, Burak Teymen, Oguz Ugur, Yavuz Enc
OBJECTIVE: To evaluate the efficacy of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the treatment of patients with massive and submassive pulmonary embolism (PE). METHOD: Twenty-two patients (13 males and nine females; age range, 38 to 71 years; mean age, 53.7 years) with massive or submassive PE were treated with UACDT with the EKOS EkoSonic® system. All patients exhibited acute symptoms, computed tomography (CT) evidence of large thrombus burden, and evidence of right ventricular (RV) dysfunction and/or failure...
July 2014: Journal of Cardiac Surgery
Aarti C Bavare, Swati X Naik, Peter H Lin, Mun Jye Poi, Donald L Yee, Ronald A Bronicki, Joseph X Philip, Moreshwar S Desai
BACKGROUND: Catheter-directed thrombolytic (CDT) therapies for severe pulmonary embolism (PE) have been shown to be effective and safe when compared with systemic thrombolysis in adults. Pediatric studies assessing efficacy and safety of CDT for PE are lacking. Hence, our aim was to review CDT as a therapy for pediatric PE. METHODS: We retrospectively reviewed charts of patients aged <18 years, who underwent CDT for main or major branch pulmonary artery occlusion associated with hypotension or right ventricular dysfunction secondary to PE during a 3-year period, in our tertiary care academic Pediatric Intensive Care Unit...
October 2014: Annals of Vascular Surgery
M Dumantepe, I A Tarhan, A Ozler
OBJECTIVE: To evaluate the feasibility, efficacy and safety of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the delayed treatment of lower extremity deep venous thrombosis (DVT). DESIGN: Twelve patients with unilateral iliofemoral or femoropopliteal DVT (mean symptom duration 92 ± 44 days) were prospectively investigated. METHOD: UACDT was performed using recombinant human tissue plasminogen activator delivered using the EKOS EkoSonic system...
September 2013: European Journal of Vascular and Endovascular Surgery
Robert J Kennedy, Hai H Kenney, Brian L Dunfee
PURPOSE: To evaluate retrospectively the safety profile and clinical success of ultrasound-accelerated thrombolysis for acute pulmonary embolism (PE) with a standard lytic infusion protocol. MATERIALS AND METHODS: A retrospective study was performed at a single center treating patients with acute PE between October 2009 and April 2012. On diagnosis of submassive or massive PE by pulmonary computed tomography angiography or ventilation/perfusion scan, all patients received anticoagulation and treatment using the EkoSonic endovascular system (EKOS Corporation, Bothell, Washington)...
June 2013: Journal of Vascular and Interventional Radiology: JVIR
Mert Dumantepe, Tarhan Ibrahım Arif, Yurdakul Ilhan, Arzu Ozdemir, Ozler Azmi
Pregnancy and the postpartum period are generally considered as contraindications for thrombolysis. We evaluate in this report the safety and effectiveness of using ultrasound-accelerated catheter-directed thrombolysis (UACDT) in treating three symptomatic postpartum deep vein thrombosis (DVT). UACDT was performed using a recombinant human tissue plasminogen activator (alteplase) which was delivered using the EKOS EkoSonic® system. Postprocedure venography was repeated after treatment which include stenting if stenosis was present...
December 2013: Vascular
Mert Dumantepe, Arif Tarhan, Ilhan Yurdakul, Azmi Özler
PURPOSE: We aimed to evaluate the efficacy and feasibility of ultrasonography (US)-accelerated catheter-directed thrombolysis for the treatment of deep venous thrombosis. MATERIALS AND METHODS: A total of 26 patients with deep venous thrombosis were prospectively selected for thrombolysis. Overall, 80.8% of the occlusions were in the lower extremities, and 19.2% were in the upper extremities. US-accelerated catheter-directed thrombolysis was performed using a recombinant human tissue plasminogen activator (alteplase), which was delivered using the EKOS EkoSonic® Endovascular System (EKOS Corporation, Bothell, Washington, USA)...
May 2013: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Kaushal J Shah, Robert M Scileppi, Randall W Franz
Traditional therapy for pulmonary embolism includes systemic anticoagulation, systemic thrombolysis, catheter-directed thrombolysis / suction catheter thrombectomy, and surgical thromboembolectomy. Currently, the standard treatment for submassive and massive pulmonary embolism involves the use of systemic anticoagulation. However, unlike systemic anticoagulation there is no standard treatment algorithm for the use of thrombolytics to aggressively treat pulmonary embolism and its sequelae. This case report discusses the successful use of thrombolytics using the EKOS EkoSonic Ultrasound-Accelerated Thrombolysis System in the treatment of bilateral submassive pulmonary emboli along with a saddle pulmonary embolus...
August 2011: Vascular and Endovascular Surgery
J Grommes, R Strijkers, A Greiner, A H Mahnken, C H A Wittens
OBJECTIVE: One in four patients with primary iliofemoral deep vein thrombosis (DVT) develops post-thrombotic syndrome (PTS) within 1 year despite optimal standard anticoagulant therapy. Removal of thrombus by thrombolytic drugs may prevent PTS. The aim of this study was to assess the short-term safety and efficacy of ultrasound-accelerated catheter-directed thrombolysis (US-accelerated CDT). DESIGN: This was a prospective non-randomised interventional study with US-accelerated CDT for DVT...
April 2011: European Journal of Vascular and Endovascular Surgery
Glenn W Stambo, Brian Montague
No abstract text is available yet for this article.
October 2010: American Journal of Emergency Medicine
Glenn W Stambo, Brian Montague
Pulmonary embolism is a common and sometimes devastating disease caused by many factors, most commonly deep venous thrombosis. Treatment is typically systemic anticoagulation depending on patient clinical presentation. For patients with life threatening pulmonary embolism, IV tPA (Activase, Genentech, South San Francisco, CA) is the most common medication given emergently at the time of presentation. Computed tomography angiography (CTA) of the chest has advanced the diagnosis and potential treatment options for patients with life threatening pulmonary embolism...
May 2010: Southern Medical Journal
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