Pulmonary Embolism in COVID-19 Treated with VA-ECLS and Catheter tPA.

IF 1 Q4 RESPIRATORY SYSTEM Clinical Medicine Insights-Circulatory Respiratory and Pulmonary Medicine Pub Date : 2020-09-03 eCollection Date: 2020-01-01 DOI:10.1177/1179548420957451

Arda Akoluk, Usman Mazahir, Steven Douedi, Adel Aziz, Aref Obagi, Daniel Kiss, Daniel Flynn, Eric Costanzo, Sinan A Simsir, Matthew D Saybolt

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引用次数: 6

Abstract

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: 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: 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.

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VA-ECLS联合tPA导管治疗COVID-19肺栓塞。

背景:新型冠状病毒2019 (COVID-19)自2020年3月被宣布为大流行以来，一直是医学界关注的焦点。虽然COVID-19的发病机制和异质性尚未完全清楚，但病毒逃避细胞免疫反应和炎症失调被认为在疾病进展和严重程度中发挥重要作用。病例介绍:我们报告了首例经全身溶栓、VA-ECLS和保底导管定向溶栓成功治疗的COVID-19合并大面积肺栓塞患者。在华法林抗凝治疗的一个重要的医院疗程后，他出院了。结论:我们报告了首例采用全身溶栓、VA-ECLS和气囊导管定向溶栓成功治疗的COVID-19合并大面积肺栓塞(PE)患者。根据我们的经验，尽管使用机械循环支持，特别是对血管通路和剂量反应监测的细致关注，导管定向溶栓仍有可接受的出血风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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