Date of Award

2027

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

Ashley Kernicky

Abstract

A pulmonary embolism is a blood clot that develops within a blood vessel and travels to the lungs, leading to a blockage of blood flow where it can cause life threatening complications.1 Currently, there is not one standard treatment for pulmonary embolisms. Treatment depends on the size and location of the emboli, as well as the risk it has to the patients’ health.9 While systemic anticoagulation is one of the most common treatment methods for pulmonary embolisms, catheter directed thrombolysis rapidly dissolves the clot, which can lead to quicker symptom relief and decreased strain on the heart.11 The purpose of this literature review article is to determine if catheter directed thrombolysis is a superior method in comparison to the use of oral anticoagulation therapy for the treatment and outcomes of patients with pulmonary embolisms. In order to conduct research on the topic, PubMed was searched using key terms including pulmonary embolism, catheter directed thrombolysis, anticoagulation therapy, and outcomes. Additional search filters were applied including five years, full text, meta-analysis, randomized controlled trial, and systematic review which produced 14 results. A total of three articles were selected and appraised, with two articles comparing the effects of CDT plus systemic anticoagulation versus systemic anticoagulation alone, and one of the articles comparing CDT versus systemic anticoagulation. Reviewed evidence from each articles suggests that the use of catheter directed thrombolysis improved in hospital, 30-day, 90-day, and one-year mortality outcomes. Catheter directed thrombolysis should be considered in the treatment of sub-massive pulmonary embolisms, and further research, including the use of larger randomized control trials, may show that it could be beneficial for all risk stratification categories including high risk (massive), intermediate risk (sub massive) and low risk pulmonary embolisms.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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