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Benefiting from Pulmonary Embolism Response Teams

Benefiting from Pulmonary Embolism Response Teams

Patients with massive or sub-massive pulmonary embolisms (PEs) often face poor survival odds—not necessarily due to the severity of their disease, but because their treatment is often suboptimal or treated too conservatively. This patient population is critically ill but often misdiagnosed as having acute myocardial infarction (MI). These factors may contribute to PE being one of the most common causes of death in the United States. In order to reverse high mortality rates associated with PE, the Detroit Medical Center created a PE Response Team (PERT) in 2014. The team was designed to treat PE patients as quickly as possible using advanced modalities, including ultrasound-accelerated, catheter-directed thrombolysis. For a study published in Cath Lab Digest, Mahir Elder, MD, and colleagues assessed more than 1,500 cases of patients hospitalized with acute PE. “We found that patients who were treated with standard systemic thrombolysis had higher in-hospital mortality and intracranial hemorrhage than those who were treated with catheter-directed thrombolysis,” says Dr. Elder. “To date, the 250 patients who have been treated by our PERT team—called Clotbusters—have a 10% mortality rate, whereas patients at our institution with massive or sub-massive PE who received systemic tPA or heparin have a 60% mortality rate.”   All About PERT The Detroit Medical Center PERT includes interventional cardiologists, nurses, cardiovascular technologists, and radiation therapists. Initially, referrals to Clotbusters came from emergency physicians with hypotensive patients who needed immediate treatment. “Now, pulmonologists, oncologists, and surgeons with ICU patients who develop PEs activate the pager that mobilizes our team 24 hours per day, 7 days per week,” says Dr. Elder. “We also get referrals from many emergency departments...
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