Prognostic markers in patients with acute pulmonary embolism submitted to reperfusion by endovascular methods

• Grant number: 17/26871-9
• Support Opportunities: Scholarships abroad - Research
• Start date: July 03, 2018
• End date: September 28, 2018
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Caio Júlio César dos Santos Fernandes
• Grantee: Caio Júlio César dos Santos Fernandes
• Host Investigator: Samuel Zachary Goldhaber
• Host Institution: Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (ICESP). Coordenadoria de Serviços de Saúde (CSS). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Institution abroad: Brigham and Women's Hospital (BWH), United States

Abstract

Venous thromboembolism is a highly prevalent disease worldwide. Its most severe manifestation is acute pulmonary thromboembolism. This condition is potentially fatal by causing cardiogenic shock by acute elevation of pulmonary vascular resistance and right ventricular failure. Treatment of more severe forms of acute pulmonary thromboembolism requires reduction of pulmonary vascular resistance. Several therapeutic modalities have already been evaluated in this context, such as systemic fibrinolysis or surgical embolectomy, but the complication rates, mainly severe and intra-cranial bleeding are still high. Recently a new approach in massive and sub-massive acute pulmonary thromboembolism has gained importance in the medical literature. The use of endovascular devices demonstrates potential efficacy, with considerable reperfusion rates, and safety, reducing bleeding rates. In addition, such devices may be combined with thrombolysis methods such as mechanical fragmentation, ultrasonic waves or combined with low-dose fibrinolytics. This project aims to evaluate prognostic variables of efficacy and safety in a population of patients with massive acute and sub-massive PE. These patients underwent reperfusion with an endo-vascular catheter with ultrasonic waves combined with low-dose fibrinolysis (24 mg t-PA). The objective is to identify patients with better clinical and hemodynamic profile to benefit from this therapeutic modality, and who have a lower risk of severe bleeding. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

FERNANDES, JR., CAIO J.; MORINAGA, LUCIANA T. K.; ALVES, JOSE L.; CASTRO, MARCELA A.; CALDERARO, DANIELA; JARDIM, CARLOS V. P.; SOUZA, ROGERIO. Cancer-associated thrombosis: the when, how and why. EUROPEAN RESPIRATORY REVIEW, v. 28, n. 151, MAR 31 2019. (17/26871-9)

FERNANDES, CAIO J.; STEIGNER, MICHAEL L.; PIAZZA, GREGORY; GOLDHABER, SAMUEL Z.. Collaborative Cardiology and Pulmonary Management of Pulmonary Hypertension. CHEST, v. 156, n. 2, p. 3-pg., 2019-08-01. (17/26871-9)