医学
肺栓塞
荟萃分析
观察研究
内科学
溶栓
置信区间
随机对照试验
重症监护医学
导管
外科
心肌梗塞
作者
Ahmed K. Pasha,Muhammad Umer Siddiqui,Muhammad Danial Siddiqui,Adnan Ahmed,Ammar Abdullah,Irbaz Bin Riaz,M. Hassan Murad,Haraldur Bjarnason,Waldemar E. Wysokiński,Robert D. McBane
标识
DOI:10.1007/s11239-021-02556-7
摘要
To compare the efficacy and safety of systemic and catheter directed thrombolysis for patients with pulmonary embolism. Pubmed and Cochrane Central Register of Controlled Trials were systematically searched from inception to May 31st 2020 to identify relevant studies. Outcomes of interest were in-hospital mortality and major bleeding including intracranial hemorrhage. We included 8 observational studies comprising 11,932 patients with PE. Catheter directed thrombolysis was associated with lower in-hospital mortality [RR 0.52; 95% confidence interval (CI) 0.40-0.68]. Although there was no difference in major bleeding by treatment strategy (RR 0.80; 95% CI 0.37-1.76), intracranial hemorrhage was lower in patients receiving catheter directed therapy (RR 0.66; 95% CI, 0.47-0.94).The certainty in these estimates was low. Non-randomized studies suggest that catheter directed delivery of thrombolytic therapy may be associated with lower in-hospital mortality and intracranial hemorrhage rates. These results may help inform management strategies for health care and pulmonary embolism response teams (PERT) involved in the management of high risk patients with massive or submassive pulmonary emboli.
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