PMID- 37216692
OWN - NLM
STAT- MEDLINE
DCOM- 20230524
LR  - 20230823
IS  - 2448-5667 (Electronic)
IS  - 0443-5117 (Print)
IS  - 0443-5117 (Linking)
VI  - 61
IP  - 3
DP  - 2023 May 2
TI  - [Ultrasound-accelerated thrombolysis. Initial experience in patients with 
      contraindications to systemic thrombolysis].
PG  - 370-379
AB  - BACKGROUND: acute pulmonary embolism (APE) is a complex and potentially deadly 
      entity, with a variable clinical course, considered the third cardiovascular 
      cause of death. Its management varies according to the stratified risk from 
      anticoagulation to reperfusion therapy, suggesting systemic thrombolysis as a 
      first-choice strategy; however, in a large group of patients their use will be 
      contraindicated, discouraged or will have failed, thus recommending as options in 
      such cases endovascular therapies or surgical embolectomy. With the presentation 
      of 3 clinical cases and a review of the literature, we seek to communicate our 
      initial experience in the use of ultrasound-accelerated thrombolysis with the 
      EKOS system and to investigate key elements for its understanding and 
      application. CLINICAL CASES: the cases of 3 patients with APE of high and 
      intermediate risk with contraindications for systemic thrombolysis taken to 
      accelerated thrombolysis therapy by ultrasound are discussed. They presented 
      adequate clinical and hemodynamic evolution in the short term, achieving a rapid 
      decrease in thrombolysis, systolic and mean pulmonary arterial pressure, 
      improvement of right ventricular function and reduction of thrombotic burden. 
      CONCLUSION: Ultrasound-accelerated thrombolysis is a novel pharmaco-mechanical 
      therapy that combines the emission of ultrasonic waves with the infusion of a 
      local thrombolytic agent, a strategy that, according to different trials and 
      clinical registries, has a high success rate and a good safety profile.
CI  - (c) 2023 Revista Medica del Instituto Mexicano del Seguro Social.
FAU - Inzunza-Cervantes, Gustavo
AU  - Inzunza-Cervantes G
AUID- ORCID: 0000-0002-0038-6068
AD  - Instituto Mexicano del Seguro Social, Centro Medico Nacional del Noroeste, 
      Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Servicio de 
      Cardiologia. Ciudad Obregon, Sonora, Mexico.
FAU - Velarde-Perez, Daniel
AU  - Velarde-Perez D
AUID- ORCID: 0000-0001-5031-3214
AD  - Instituto Mexicano del Seguro Social, Centro Medico Nacional del Noroeste, 
      Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Servicio de 
      Cardiologia. Ciudad Obregon, Sonora, Mexico.
FAU - Saldana-Garcia, Jose Hernando
AU  - Saldana-Garcia JH
AUID- ORCID: 0000-0002-7131-7799
AD  - Instituto Mexicano del Seguro Social, Centro Medico Nacional del Noroeste, 
      Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Servicio de 
      Cardiologia Intervencionista. Ciudad Obregon, Sonora, Mexico.
FAU - Espinoza-Escobar, Gabriela
AU  - Espinoza-Escobar G
AUID- ORCID: 0000-0001-6166-7368
AD  - Instituto Mexicano del Seguro Social, Centro Medico Nacional del Noroeste, 
      Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Servicio de 
      Cardiologia. Ciudad Obregon, Sonora, Mexico.
FAU - Velazquez-Mejia, Felipe de Jesus
AU  - Velazquez-Mejia FJ
AUID- ORCID: 0000-0002-2157-6135
AD  - Instituto Mexicano del Seguro Social, Centro Medico Nacional del Noroeste, 
      Hospital de Especialidades No. 2 "Luis Donaldo Colosio Murrieta", Servicio de 
      Cardiologia. Ciudad Obregon, Sonora, Mexico.
LA  - spa
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Trombolisis acelerada por ultrasonido. Experiencia inicial en pacientes con 
      contraindicacion para trombolisis sistemica.
DEP - 20230502
PL  - Mexico
TA  - Rev Med Inst Mex Seguro Soc
JT  - Revista medica del Instituto Mexicano del Seguro Social
JID - 101243727
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Humans
MH  - Animals
MH  - Treatment Outcome
MH  - Fibrinolytic Agents/therapeutic use
MH  - Thrombolytic Therapy/adverse effects
MH  - *Pulmonary Embolism/drug therapy
MH  - Contraindications
MH  - *Hominidae
PMC - PMC10437234
OTO - NOTNLM
OT  - Pulmonary Embolism
OT  - Therapeutic Thrombolysis
OT  - Ultrasound-Accelerated Thrombolysis
COIS- los autores han completado y enviado la forma traducida al espanol de la 
      declaracion de conflictos potenciales de interes del Comite Internacional de 
      Editores de Revistas Medicas, y no fue reportado alguno que tuviera relacion con 
      este articulo.
EDAT- 2023/05/22 19:11
MHDA- 2023/05/24 06:42
PMCR- 2023/05/01
CRDT- 2023/05/22 17:44
PHST- 2022/08/30 00:00 [received]
PHST- 2022/09/22 00:00 [accepted]
PHST- 2023/05/24 06:42 [medline]
PHST- 2023/05/22 19:11 [pubmed]
PHST- 2023/05/22 17:44 [entrez]
PHST- 2023/05/01 00:00 [pmc-release]
PST - epublish
SO  - Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):370-379.