Pulmonary Embolism in COVID-19 Treated with VA-ECLS and Catheter tPA.
COVID-19
VA-ECMO
pulmonary embolism
tPA
thrombolysis
Journal
Clinical medicine insights. Circulatory, respiratory and pulmonary medicine
ISSN: 1179-5484
Titre abrégé: Clin Med Insights Circ Respir Pulm Med
Pays: United States
ID NLM: 101537753
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
05
2020
accepted:
13
08
2020
entrez:
21
9
2020
pubmed:
22
9
2020
medline:
22
9
2020
Statut:
epublish
Résumé
Novel coronavirus 2019 (COVID-19) has been the focus of the medical world since being declared a pandemic in March 2020. While the pathogenesis and heterogeneity of COVID-19 manifestations is still not fully understood, viral evasion of cellular immune responses and inflammatory dysregulation are believed to play essential roles in disease progression and severity. We present the first case of a patient with COVID-19 with massive pulmonary embolism treated successfully with systemic thrombolysis, VA-ECLS, and bail out catheter directed thrombolysis. He was discharged from the hospital after an eventful hospital course on therapeutic anticoagulation with warfarin. We present the first case of a patient with COVID-19 with massive pulmonary embolism (PE) treated successfully with systemic thrombolysis, VA-ECLS and bail out catheter directed thrombolysis. In our experience catheter directed thrombolysis comes with an acceptable bleeding risk despite use of mechanical circulatory support, particularly with meticulous attention to vascular access and dose response monitoring.
Sections du résumé
BACKGROUND
BACKGROUND
Novel coronavirus 2019 (COVID-19) has been the focus of the medical world since being declared a pandemic in March 2020. While the pathogenesis and heterogeneity of COVID-19 manifestations is still not fully understood, viral evasion of cellular immune responses and inflammatory dysregulation are believed to play essential roles in disease progression and severity.
CASE PRESENTATION
METHODS
We present the first case of a patient with COVID-19 with massive pulmonary embolism treated successfully with systemic thrombolysis, VA-ECLS, and bail out catheter directed thrombolysis. He was discharged from the hospital after an eventful hospital course on therapeutic anticoagulation with warfarin.
CONCLUSIONS
CONCLUSIONS
We present the first case of a patient with COVID-19 with massive pulmonary embolism (PE) treated successfully with systemic thrombolysis, VA-ECLS and bail out catheter directed thrombolysis. In our experience catheter directed thrombolysis comes with an acceptable bleeding risk despite use of mechanical circulatory support, particularly with meticulous attention to vascular access and dose response monitoring.
Identifiants
pubmed: 32952405
doi: 10.1177/1179548420957451
pii: 10.1177_1179548420957451
pmc: PMC7476337
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1179548420957451Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Thromb Res. 2020 Jun;190:58-59
pubmed: 32302782
JACC Case Rep. 2020 Jul 15;2(9):1379-1382
pubmed: 32313884
Diagn Interv Imaging. 2020 May;101(5):321-322
pubmed: 32334995