Endovascular Mechanical Thromboembolus Fragmentation in the Treatment of Critical Pulmonary Thromboembolism in Patients with Acute Hemorrhagic Stroke

• DOI: 10.17691/stm2020.12.1.09
• Publication Date: 2020-03-02T06:50:57Z
• Authors: A.M. Homenko; E.A. Kusmenko; V.V. Pichugin; A.P. Medvedev
• Keywords: Stroke; Embolus

The aim of the study was to evaluate effectiveness endovascular mechanical thromboembolus fragmentation in treatment critical pulmonary thromboembolism patients with acute hemorrhagic stroke.The included 47 stroke complicated by massive high-risk manifestations right ventricular failure. All were divided into two groups depending on method: examined group (n=17) undergone and control (n=30) received only basic intensive therapy.Thromboembolus performed order transfer embolism trunk main branches smaller artery. technical success procedure (destruction central thromboembolus) achieved 100% cases. 14 (82.4%) showed positive clinical dynamics: improvement general condition, reduction artery pressure, decreased volume bed damage according CT angiography. Three (17.6%) died early postoperative period. Twenty five from died, hospital mortality rate 83.3%. There no deaths after 6-9 months follow-up, signs hypertension persisted 11 (64.7%).Endovascular results fast safe decrease pressure. Fragmentation its displacement peripheral vascular a modified pigtail catheter is minimally invasive surgical which may be used as an alternative embolectomy cases extremely high risk surgery absolute contraindications thrombolytic therapy.