The Particulars: Research indicates that patients with submassive pulmonary embolism (PE)—unlike those with massive PE—are typically managed conservatively despite right ventricular (RV) dysfunction that could result in poor outcomes if unresolved. Ultrasound-accelerate thrombolysis (USAT) may represent a safe, more aggressive treatment approach for patients with both massive and submassive PE.
Data Breakdown: A retrospective evaluation was conducted in seven patients with massive PE and another 50 patients with submassive PE who were treated with USAT. The authors found that the right-ventricle-to-left-ventricle diameter (RV/LV) ratio was reduced from 1.5 at baseline to 1.0 at 48 hours follow-up. Data from 30-day follow-up found that the RV/LV ratio in six patients was further reduced to a range of 0.6 to 0.9. For USAT recipients, the average length of stay was 1 day in the ICU and 7 days in the hospital. No in-hospital mortalities were observed in the study.
Take Home Pearls: Patients with both massive and submassive PE who undergo USAT appear to achieve rapid resolution of RV dysfunction. This resolution appears to continue to improve with time.