Dynamics in creatinine in patients with heart failure presenting with pulmonary embolism treated by ultrasound-assisted, catheter-directed thrombolysis versus mechanical thrombectomy: single center
J Bogoviku, S Dinesh, J G Westphal, F Haertel, S Moebius-Winkler, P C SchulzeAbstract
Background
Patients with intermediate-high or high-risk pulmonary embolism (PE) present with a high morbidity and mortality. Ultrasound-assisted, catheter-directed thrombolysis and mechanical thrombectomy are emerging interventional therapies which are used in the acute and subacute phase, especially in the event of acute right heart failure. Creatinine represents a widely available and robust parameter to assess renal function.
Am / Purpose
The aim of this retrospective analysis was to evaluate the impact of USAT and MT in intermediate-high or high-risk PE.
Methods
Patients who presented with intermediate-high or high-risk PE between October 2017 and September 2024 and treated with USAT or MT were evaluated retrospectively. Both procedures were performed within 24 hours following hospital admission. Blood serum levels of creatinine were assessed before the intervention and after 24 hours.
Results
127 patients received interventional treatment. 101 patients were treated using UST and 26 using MT. 20 patients presented with chronic heart failure. Baseline characteristics are highlighted in Table 1. Creatinine at admission (109 ± 47 [82-137] µmol/l vs 149 ± 138 [4.3-295] µmol/; p=0.904) and post procedural (93 ± 33 [74-111] µmol/l vs 165 ± 182 [-26-357] µmol/l; p=0.494) didn’t show a statistical significance between the to cohorts. At hospital discharge we detected a decrease in both cohorts, with a lower level in the USAT cohort (83 ± 32 [63-103 µmol/l) compared to MT (99 ± 24 [73-124] µmol/l). This dynamic didn’t translate in a statistical significance (p=0.437).
Conclusion
Our data suggest that USAT leads to lower creatinine levels post procedural. On contrast we could detect a light increase in the MT cohort. At discharge we could detect a decrease in both cohorts. These changes didn’t present a statistical significance. These aspects may translate in the short time safety of USAT and MT regarding renal function in patients with chronic heart failure who present with intermediate-high or high-risk PE.For image description, please refer to the figure legend and surrounding text.