医学
荟萃分析
肺栓塞
溶栓
科学网
梅德林
内科学
导管
血流动力学
科克伦图书馆
心脏病学
外科
心肌梗塞
政治学
法学
作者
Mehrdad Farrokhi,Maria Khurshid,Bardia Yarmohammadi,Amir Mangouri,Yalda Alipour-Khabir,Sevda Alipour-Khabir,Nasibeh Sargazi Moghadam,Shima Mosalanejad,Sama Nourizadeh,Sina Jafari,Reza Amani-Beni,Seyyed-Mohammad Hosseini-Saryazdi,Shiva Zarei,Sahar Sanjarian,Hesam-Aldin Babasafari,Shiva Shakori Poshteh,Negar Masoudi,Reza Zahedpasha,Moein Kiani,Fateme Jalalifar,Fatemeh Taheri
出处
期刊:Perfusion
[SAGE]
日期:2022-06-20
卷期号:38 (6): 1123-1132
标识
DOI:10.1177/02676591221108811
摘要
Background Acute submassive a massive pulmonary embolism are known as leading causes of cardiovascular morbidity and mortality in emergency departments. Choosing the optimal type of catheter directed thrombolysis (CDT) for treatment of pulmonary embolism presents a quandary to the practitioners. To the best of our knowledge, there is no meta-analysis comparing superiority of conventional CDT and ultrasound-accelerated catheter directed thrombolysis (USACDT). Therefore, in this meta-analysis, we aimed to compare conventional CDT with USACDT regarding clinical outcomes and safety profile. Methods A systematic literature search of previous published studies comparing conventional CDT with USACDT regarding clinical outcomes and safety profile was carried out in the electronic databases including MEDLINE, Scopus, EBSCO, Google Scholar, Web of Science, and Cochrane from inception to December 2021. Data were analyzed by comprehensive meta-analysis software (CMA, version 3). Results The meta-analysis included nine studies with a total of 705 patients. Our meta-analysis showed that there is no significant difference between two groups with respect to pulmonary arterial systolic pressure (SMD: −0.084; 95% CI: −0.287 to 0.12; p: 0.41), RV/LV (SMD: −0.003; 95% CI: −0.277 to 0.270; p: 0.98), and Miller score (SMD: −0.345; 95% CI: −1.376 to 0.686; p: 0.51). Similarly, we found no statistically significant differences between two groups regarding major and minor bleeding ( p > .05). Conclusion Our meta-analysis showed that when compared with USACDT, conventional CDT provides similar clinical and hemodynamic outcomes or safety for treatment of pulmonary embolism without the need for very expensive technologies. However, randomized clinical trials are required to further investigate cost-effectiveness of USACDT in comparison with conventional CDT.
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