Research Article
Volume 9 Issue 7 - 2020
Catheter Directed Thrombolysis in Patient with COVID-19 Pneumonia and Acute High-Risk Pulmonary Embolism
Mert Dumantepe1*, Hacer Kuzu Okur2, Emre Sahillioğlu3, Murat Okten1, Nalan Karadag4, Alper Ozkan4, Yasemin Gundogdu5, Selim Isbir1 and Hasan Karabulut1
1Department of Cardiovascular Surgery, Acibadem Altunizade Hospital, Istanbul, Turkey
2Department of Pulmonary Medicine, Acibadem Altunizade Hospital,Turkey
3Department of Anesthesiology, Acibadem Altunizade Hospital, Istanbul, Turkey
4Department of Cardiology, Acibadem Altunizade Hospital, Istanbul, Turkey
5Department of Internal Medicine, Acibadem Altunizade Hospital, Istanbul, Turkey
*Corresponding Author: Mert Dumantepe, Department of Cardiovascular Surgery, Acibadem Altunizade Hospital, Istanbul, Turkey.
Received: May 28, 2020; Published: June 29, 2020


Background: Coronavirus disease 19 (COVID-19) is a worldwide infection which was recently declared a global health emergency by the WHO Emergency Committee. The effects of severe illness, hypoxia and microangiopathy may predispose patients to Venous Thromboembolism (VTE) events in COVID-19. However, the incidence is VTE in COVID-19 infected patients is still unknown.

Methods: We studied consecutive symptomatic patients with proven COVID-19 infection admitted to Acibadem University Hospital in Istanbul, Turkey (15.3.2020 - 15.05.2020). The primary outcome was any venous thromboembolic complications and secondary outcome was analyze rates of subsegmental Pulmonary Embolism (PE) with or without deep vein thrombosis.

Results: We included 358 consecutive patients with laboratory proven COVID-19 pneumonia. Mean age was 54.3 ± 17.4 years (range, 36 to 81 years), and 226 (63.1%) were men. A total of 77 (21.5%) patients required intensive care unit (ICU) admission; the remaining 281 (78.5%) patients were admitted to general wards. Of those patients, 13 (3.6%) were died, 319 (89.2%) were discharged alive and 26 (7.2%) were still in the hospital on May 15th 2020. VTE events occurred in 61 of 352 patients for the cumulative rate of 17% during the study period. Surprisingly, we found that 22 of 25 (88%) subsegmental PE patients have no proven deep vein thrombosis, which is corroborated the pulmonary immuno-thrombosis theory.

Conclusion: The high incidence of VTE events suggests an important role of COVID-19 induced coagulopathy. Thus, repeated assessment and optimized treatment are necessary to reduce the occurrence of VTE and prevent fatal PE events. Our retrospective study demonstrates successful results of patients with high-risk PE using EKOSÔ APT treatment. Although patients have COVID-19 infection, interventional treatment modalities demonstrate safe, promising and reproducible results.

Keywords: COVID-19; Acoustic Pulse Thrombolysis, Anticoagulation; Pulmonary Embolism; Venous Thromboembolism; VA-ECMO


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Citation: Mert Dumantepe., et al. “Catheter Directed Thrombolysis in Patient with COVID-19 Pneumonia and Acute High-Risk Pulmonary Embolism”. EC Pulmonology and Respiratory Medicine 9.7 (2020): 129-138.

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