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Título:	Catheter-directed therapies in patients with pulmonary embolism: predictive factors of in-hospital mortality and long-term follow-up
Autor/a:	Ribas, Jesús; Valcárcel, Joana; Alba, Esther; Ruíz, Yolanda; Cuartero, Daniel; Iriarte, Adriana; Mora-Luján, José María; Huguet, Marta; Cerdà, Pau; Martínez-Yélamos, Sergio; Corbella Virós, Xavier; Santos, Salud; Riera-Mestre, Antoni
Notas:	Background: Catheter-directed therapies (CDT) may be considered for selected patients with pulmonary embolism (PE); (2) Methods: Retrospective observational study including all consecutive patients with acute PE undergoing CDT (mechanical or pharmacomechanical) from January 2010 through December 2020. The aim was to evaluate in-hospital and long-term mortality and its predictive factors; (3) Results: We included 63 patients, 43 (68.3%) with high-risk PE. All patients underwent mechanical CDT and, additionally, 27 (43%) underwent catheter-directed thrombolysis. Twelve (19%) patients received failed systemic thrombolysis (ST) prior to CDT, and an inferior vena cava (IVC) filter was inserted in 28 (44.5%) patients. In-hospital PE-related and all-cause mortality rates were 31.7%; 95% CI 20.6–44.7% and 42.9%; 95% CI 30.5–56%, respectively. In multivariate analysis, age > 70 years and previous ST were strongly associated with PE-related and all-cause mortality, while IVC filter insertion during the CDT was associated with lower mortality rates. After a median follow-up of 40 (12–60) months, 11 more patients died (mortality rate of 60.3%; 95% CI 47.2–72.4%). Long-term survival was significantly higher in patients who received an IVC filter; (4) Conclusions: Age > 70 years and failure of previous ST were associated with mortality in acute PE patients treated with CDT. In-hospital and long-term mortality were lower in patients who received IVC filter insertion.
Materia(s):	-Procediments endovasculars -Mortalitat -Embòlia pulmonar -Trombectomia -Teràpia trombolítica -Filtres de vena cava -Procedimientos endovasculares -Mortalidad -Embolia pulmonar -Trombectomía -Terapia trombolítica -Filtros de vena cava -Endovascular procedures -Mortality -Pulmonary embolism -Thrombectomy -Thrombolytic therapy -Vena cava filters -61
Derechos:	This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Tipo de documento:	Artículo Artículo - Versión publicada
Editor:	MDPI
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