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What To Know About Pulmonary Embolism?
A pulmonary embolism is a blockage in the pulmonary artery that supplies blood to the lungs. The blockage, usually caused by a blood clot, impairs oxygenation of the blood and can damage the heart. This means it can be life threatening.
The word "embolism" comes from the Greek émbolos, meaning "stopper" or "plug."
In a pulmonary embolism, the embolus forms in one part of the body and circulates throughout the blood supply. It then blocks the blood flowing through a vessel in another part of the body, namely the lungs. Blood clots often develop in the leg, which is called deep vein thrombosis (DVT).
This article lists the symptoms of pulmonary embolism and outlines its diagnosis and treatment options.
Although the exact number of those affected by pulmonary embolism or DVT is unknown, it may affect as many as 900,000 people in the United States each year.
The National Heart, Lung, and Blood Institute notes that a person may not experience any symptoms of a pulmonary embolism. Others may experience symptoms that develop within seconds to minutes or over days to weeks. The symptoms can also start mild and become more severe.
Common symptoms include:
Less common symptoms include:
Severe symptoms call for immediate emergency medical assistance. More severe cases may result in shock, loss of consciousness, cardiac arrest, and death.
Treatments for a pulmonary embolism aim to:
The main treatment option for pulmonary embolism is anticoagulation.
A doctor will prescribe anticoagulants or blood-thinning medications, such as warfarin, heparin, or direct oral anticoagulants, to stop blood clots from getting bigger and prevent new clots from forming.
They may administer an anticoagulant as soon as they suspect a pulmonary embolism before they have made a definitive diagnosis.
A person will then need to take anticoagulants for approximately 3 months or longer.
For large blood clots causing severe symptoms or complications, a doctor may prescribe an intravenous thrombolytic. However, these carry a high risk of excessive bleeding. Thrombolytics include Activase, Retavase, and Eminase.
In emergencies, a person may require surgery, such as catheter-assisted blood clot removal. A catheter-assisted blood clot removal requires a surgeon inserting a flexible tube to reach the blood clot in the lung. They can then insert a tool to break up the clot or administer medication.
A pulmonary embolism occurs when an embolus, usually a blood clot, blocks the blood flowing through an artery that feeds the lungs.
A blood clot may start in an arm or leg, known as deep vein thrombosis (DVT).
After that, it breaks free and travels through the circulatory system toward the lungs. When the embolus is too large to pass through the small vessels, it forms a blockage.
This blockage stops blood from flowing into a part of the lung. This causes the affected section of the lung to die through lack of oxygen. The blood clot can also cause pressure to build in the right side of the heart, eventually causing heart failure.
Rarely, a pulmonary embolism can result from an embolus that is formed from fat droplets, amniotic fluid, or some other particle that enters the bloodstream.
The risk factors for developing a pulmonary embolism can be genetic or acquired.
Some acquired risk factors include:
To reduce the risk of developing a blood clot or pulmonary embolism, a person can:
A person undergoing surgery should discuss a plan to prevent blood clots with a healthcare professional. They will also advise on how to prevent blood clots during the recovery period.
Those with a high risk of developing pulmonary embolism may require anticoagulant medications.
To reach a diagnosis, the doctor will look at the person's history and consider whether they are likely to have an embolism. They will carry out a physical examination. Doctors may find it challenging to make a diagnosis because other conditions have similar symptoms.
The doctor may perform the following tests:
A doctor may also perform other imaging tests so they can look at the veins and the function of the heart and lungs.
With effective and timely treatment, most people who experience a pulmonary embolism can make a full recovery. However, the condition can carry a high risk of fatality without timely intervention.
A person's outlook can also be affected depending on the underlying condition that caused the blood clot or pulmonary embolism.
A pulmonary embolism is a blockage in the pulmonary artery. The pulmonary artery supplies blood to the lungs. The blockage, which usually occurs due to a blood clot, prevents the oxygen from reaching the lungs.
Anyone experiencing symptoms of a pulmonary embolism should seek urgent medical help. This is because timely treatment and diagnosis can improve a person's outlook. Common symptoms include shortness of breath, rapid breathing, high heart rate, and pain when breathing deeply.
Treatment often involves anticoagulant medications. In severe cases, surgery may be necessary.
Women And Black Patients Less Likely To Receive Catheter-based Treatment For Pulmonary Embolism
New data from the REAL-PE analysis investigated catheter-based pulmonary embolism (PE) treatment, showing women and Black people were less frequently treated with minimally invasive therapy compared to men or non-Black patients. The late-breaking results were presented today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2024 Scientific Sessions.
PE is often caused by blood clots in the legs, otherwise known as deep vein thrombosis, that travel through the veins and into the lungs. PE affects around 900,000 people in the U.S. Each year, with 10–30% dying within one month of diagnosis. Ultrasound-assisted catheter-directed thrombolysis (USCDT), a common invasive treatment option for PE, enables deeper penetration of the clot-busting medication into the clot, restoring normal blood flow faster.
Mechanical thrombectomy (MT), another invasive treatment method has been shown to reduce thrombus burden and pulmonary artery pressure (PAP) and to improve right ventricular (RV) function in patients with high-risk or intermediate-high-risk PE.
REAL-PE analyzed data from patients within the Truveta database diagnosed with PE and treated with USCDT or MT for PE. Patient characteristics including race, ethnicity, age, sex, comorbidities, and prior diagnoses were assessed to investigate their association with the type of treatment used.
Of the more than 430,000 patients diagnosed with PE, about 2,000 patients analyzed were treated with one of the invasive therapies. Women or Black patients were less frequently treated with invasive therapy than men or non-Black patients. Moreover, women more than men and Black people more than white people had higher bleeding rates.
"Although this data demonstrates the value of real-world data in the assessments of new technologies in which randomized data are not always available, there is still work that needs to be done to evaluate the current utilization of advanced therapies for PE in underrepresented patient populations," said Sahil A. Parikh, MD, Associate Professor of Medicine, Columbia University Irving Medical Center, and lead author of the study.
"Evaluating care disparities in real clinical practices is key to addressing the existing barrier and improving patient outcomes."
More information: "Disparities in Pulmonary Embolism Care: Insights from Big Data Analytics," Friday, May 3, 2024; 2:02-2:09 PM PT, Long Beach Convention Center, 104A, First Level
Citation: Women and Black patients less likely to receive catheter-based treatment for pulmonary embolism (2024, May 3) retrieved 6 May 2024 from https://medicalxpress.Com/news/2024-05-women-black-patients-catheter-based.Html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
Novel Thrombectomy System Demonstrates Positive Safety And Feasibility Results In Treating Acute Pulmonary Embolism
Late-breaking data from the ENGULF trial showed that a novel dual-action thrombectomy device was effective and safe in treating acute pulmonary embolism (PE). The safety and effectiveness results were presented at the Society for Cardiovascular Angiography & Interventions (SCAI) 2024 Scientific Sessions and simultaneously published in JSCAI.
PE is a serious cardiovascular event where a blood clot causes issues with blood flow and oxygen levels in the lungs. It can be life-threatening, with up to 30% of individuals dying within one month of diagnosis. Despite recent advances in therapeutic options, PE still carries a high risk of mortality and morbidity with few FDA-cleared thrombectomy catheters available to physicians.
The ENGULF trial is a prospective, single-arm, first-in-human, safety and feasibility study evaluating a novel embolectomy catheter system for the treatment of acute PE with a steerable and expandable funnel and an internal agitator, the Hēlo PE Thrombectomy System.
Patients underwent a pre- and 48-hour post-procedural computed tomography (CT) scan. The primary efficacy outcome was the percent difference in the pre-to-post procedural right ventricle–to–left ventricle (RV/LV) ratios.
The primary and secondary safety outcomes were all-cause mortality, major life-threatening bleeding, device-related serious adverse events, pulmonary or cardiac injury, and clinical decompensation at 48 hours and 30 days post-procedure.
All 25 patients from eight centers underwent successful embolectomy. The mean RV/LV ratio was 1.53±0.27 at baseline and 1.15±0.18 at 48 hours post-procedure (23.2%±12.81% change). Of note, there were no major adverse events at 48 hours and no deaths at 30 days.
"Although more rigorous studies are needed, RV/LV ratio is the most important predictor of dysfunction and adverse outcomes in acute PE, and it is exciting to see that the RV/LV ratio reduction was just as much as other FDA-approved devices on the market without any large safety concerns in a new first-in-human device," said Tai Kobayashi, MD, Assistant Professor of Clinical Medicine at Penn Medicine, and lead author of the study.
"This technology represents the marriage between large and small-bore embolectomy, which allows for operators to travel through the heart with a smaller catheter but expand a larger funnel that matches the size of the large bore catheters—leaving a smaller footprint and lowering the risk of hemodynamic impact for the patient."
"For the field of interventional PE therapies to fully reach its promise, continued innovation is needed to optimize our procedural workflows across the wide array of patients affected by this disease," said Jay Giri MD, MPH, Director of the Cardiovascular Catheterization Laboratories at the Hospital of the University of Pennsylvania, senior author of the study, and national principal investigator of the study.
"The ENGULF trial is an important step in this process, demonstrating that a novel, purpose-built PE thrombectomy catheter can achieve excellent results even among its earliest users."
More information: "First in Human Safety and Feasibility of a Novel Catheter Thrombectomy Device for the Treatment of Pulmonary Embolism (The ENGULF Trial)" Friday, May 3, 2024; 2:26-2:33 PM PT, scai.Org/scai-2024-scientific-sessions
JSCAI (2024). DOI: 10.1016/j.Jscai.2024.102049
Citation: Novel thrombectomy system demonstrates positive safety and feasibility results in treating acute pulmonary embolism (2024, May 3) retrieved 6 May 2024 from https://medicalxpress.Com/news/2024-05-thrombectomy-positive-safety-feasibility-results.Html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
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