PMID- 28891451
OWN - NLM
STAT- MEDLINE
DCOM- 20180801
LR  - 20180813
IS  - 2212-4063 (Electronic)
IS  - 1871-529X (Linking)
VI  - 17
IP  - 2
DP  - 2017
TI  - Fibrinolytic and Anticoagulation Therapy in Patients Undergoing 
      Ultrasound-Assisted Catheter-Directed Thrombolysis for Pulmonary Embolism.
PG  - 132-135
LID - 10.2174/1871529X17666170908110328 [doi]
AB  - BACKGROUND: Ultrasound-assisted, catheter-directed thrombolysis (UA-CDT) relieves 
      right ventricular stress without a significant increase in the risk of bleeding 
      compared to systemic thrombolysis. Although concomitant anticoagulation is 
      provided to prevent thrombus expansion, the optimal anticoagulation regimen in 
      patients receiving UA-CDT remains unknown. OBJECTIVE: We sought to describe 
      anticoagulation practices for patients receiving UA-CDT. METHODS: Patients 
      receiving UA-CDT for acute pulmonary embolism (PE) between Jan 1, 2013 to Sept 
      30, 2014 at a single center were analyzed. We collected patient characteristics, 
      fibrinolytic and anticoagulant usage as well as clinical outcomes. RESULTS: 
      Fourteen patients were included in the final analysis. The mean alteplase dose 
      was 16.8 +/- 5.6 mg and 24.3 +/- 3.4 mg in unilateral and bilateral PE, respectively. 
      Mean unfractionated heparin (UFH) rates were 7.4 (+/-2.17) IU/kg/hr and 12.4 (+/-3.1) 
      IU/kg/hr during and after fibrinolytic therapy, respectively. The median aPTT was 
      42.4 sec [IQR 34.5-51.8] and 77.9 sec [IQR 66.5-96.8] during and after 
      fibrinolytic therapy, respectively. There were no recurrent VTE within 30 days of 
      hospital discharge. One patient had a major bleeding event (intracranial 
      hemorrhage). CONCLUSION: In patients with acute PE, our institution utilized low 
      levels of anticoagulation during fibrinolytic administration and therapeutic 
      doses after completion of fibrinolytic infusion. Standardized protocols for 
      anticoagulation during UA-CDT are warranted.
CI  - Copyright(c) Bentham Science Publishers; For any queries, please email at 
      epub@benthamscience.org.
FAU - Terry, Kimberly J
AU  - Terry KJ
AD  - Department of Pharmacy, University of Utah, Salt Lake City, UT, United States.
FAU - Buckley, Leo F
AU  - Buckley LF
AD  - Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth 
      University, Richmond, VA, United States.
FAU - Aldemerdash, Ahmed
AU  - Aldemerdash A
AD  - Department of Pharmacotherapy and Experimental Therapeutics, University of North 
      Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, United 
      States.
FAU - Fanikos, John
AU  - Fanikos J
AD  - Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, United 
      States.
FAU - Dell'Orfano, Heather
AU  - Dell'Orfano H
AD  - Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, United 
      States.
LA  - eng
PT  - Journal Article
PL  - United Arab Emirates
TA  - Cardiovasc Hematol Disord Drug Targets
JT  - Cardiovascular & hematological disorders drug targets
JID - 101269160
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Catheters
MH  - Drug Delivery Systems/methods
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/*therapeutic use
MH  - Heparin/administration & dosage/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Embolism/*drug therapy
MH  - Thrombolytic Therapy/*methods
MH  - Tissue Plasminogen Activator/administration & dosage/*therapeutic use
MH  - Treatment Outcome
MH  - Ultrasonics/methods
OTO - NOTNLM
OT  - Fibrinolysis
OT  - anticoagulation
OT  - embolism
OT  - heparin
OT  - pulmonary embolism
OT  - ultrasound-assisted catheter directed thrombolysis
EDAT- 2017/09/12 06:00
MHDA- 2018/08/02 06:00
CRDT- 2017/09/12 06:00
PHST- 2017/03/15 00:00 [received]
PHST- 2017/06/06 00:00 [revised]
PHST- 2017/08/08 00:00 [accepted]
PHST- 2017/09/12 06:00 [pubmed]
PHST- 2018/08/02 06:00 [medline]
PHST- 2017/09/12 06:00 [entrez]
AID - CHDDT-EPUB-85647 [pii]
AID - 10.2174/1871529X17666170908110328 [doi]
PST - ppublish
SO  - Cardiovasc Hematol Disord Drug Targets. 2017;17(2):132-135. doi: 
      10.2174/1871529X17666170908110328.