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Current Cardiology Reviews

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ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

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Meta-Analysis

Catheter-directed Thrombolysis versus Systemic Anticoagulation for Submassive Pulmonary Embolism: A Meta-Analysis

Author(s): Juan Arturo Siordia* and Amanpreet Kaur

Volume 18, Issue 1, 2022

Article ID: e030621193818 Pages: 6

DOI: 10.2174/1573403X17666210603114116

Price: $65

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Abstract

Background: The optimal therapy for submassive pulmonary embolism remains in question. The following meta-analysis compiles the current evidence comparing Catheter-Directed Thrombolysis (CDT) versus Systemic Anticoagulation (SA).

Methods: An electronic search through PubMed and Google scholar revealed studies comparing CDT versus SA in terms of mortality and major bleeding events. Thirty-day, 90-day, and one-year mortality results were analyzed.

Results: Six studies were included in the meta-analysis. Thirty-day and one-year mortality were less with CDT compared to SA (OR 0.27 [CI 0.11-0.67]; and OR 0.50 [CI 0.28-0.89]). Ninety-day mortality was similar between the two methods (OR 0.57 [CI 0.17-1.92]). Compilation of all studies reporting at least greater than 30-day mortality revealed less mortality with CDT (OR 0.51 [0.30-0.86]). Major bleeding was similar between the two treatments (OR 1.63 [CI 0.63-4.20]).

Conclusion: CDT has less 30-day and 1-year mortality with equivalent rates of major bleeding compared to SA for treatment of submassive pulmonary embolism.

Keywords: Submassive pulmonary embolism, catheter-directed thrombolysis, systematic anticoagulation, thrombolytic, heparin, hemodynamic instability.

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