Outcomes of catheter-directed thrombolysis versus systemic thrombolysis in the treatment of pulmonary embolism:a meta-analysis
Huang-Tai MIAO1
Ying LIANG2
Xiao-Ying LI3
Xiao WANG1
Hui-Juan ZUO4
Zhe-Chun ZENG4
Shao-Ping NIE1
1.Center for Coronary Artery Disease,Beijing Anzhen Hospital,Capital Medical Universisty,Beijing,China2.Emergency& Critical Care Center,Beijing Anzhen Hospital,Capital Medical University,Beijing,China3.Department of Health Care for Cadres,Beijing Jishuitan Hospital,Beijing,China4.Department of Clinical & Community Cardiovascular Disease Pre-vention,Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing Anzhen Hospital,Capital Medical University,Be-ijing,China
摘要：OBJECTIVE To evaluate the safety and efficacy of catheter-directed thrombolysis(CDT)versus systemic thrombolysis(ST)in the treatment of pulmonary embolism(PE).METHODS The Cochrane Library,PubMed,and Embase databases were searched to collect the literature on the comparison of the results of CDT and ST in the treatment of PE from the beginning of their records to May 2020,and meta-analysis was performed by STATA software(version 15.1).Using standardized data-collection forms,the authors screened the studies and independently ext-racted data,and assessed the quality of the studies using the Newcastle-Ottawa Scale for cohort studies.Cohort studies that exami-ned the following results were included in the current study:in-hospital mortality,all-cause bleeding rate,gastrointestinal bleedi-ng rate,intracranial hemorrhage rate,the incidence of shock,and hospital length of stay.RESULTS A total of eight articles,with 13,242 participants,involving 3962 participants in the CDT group and 9280 participants in the ST group were included.CDT compared with ST in the treatment of PE can significantly affect in-hospital mortality rate[od-ds ratio(OR)=0.41,95％CI:0.30-0.56,P＜0.05],all-cause bleeding rate(OR=1.20,95％CI:1.04-1.39,P=0.012),gastrointestinal ble-eding rate(OR=1.43,95％CI:1.13-1.81,P=0.003),the incidence of shock(OR=0.46,95％CI:0.37-0.57,P＜0.05),and hospital len-gth of stay[standard mean difference(SMD)=0.16,95％CI:0.07-0.25,P＜0.05].However,there was no significant effect on intracran-ial hemorrhage rate in patients with PE(OR=0.70,95％CI:0.47-1.03,P=0.070).CONCLUSIONS CDT is a viable alternative to ST in the treatment of PE,as it can significantly reduce in-hospital mortality rate,all-cause bleeding rate,gastrointestinal bleeding rate,and incidence of shock.However,CDT may prolong hospital length of stay to a certain extent.Further research is needed to evaluate the safety and efficacy of CDT and ST in the treatment of acute PE and other clinical outcomes.
机标关键词：meta-analysiscatheterdirectedembolismoutcomespulmonarysystemicthrombolysis
论文发表日期：2023-06-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 459-468 )