Surgical Pulmonary Embolectomy With No Systemic Anticoagulation for Patient With Recent Stroke.

Surgical Pulmonary Embolectomy With No Systemic Anticoagulation for Patient With Recent Stroke.
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DOI:
10.1016/j.athoracsur.2020.04.033
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发表时间:
2020-12
期刊:
The Annals of thoracic surgery
影响因子:
--
通讯作者:
Gosev I
Gosev I
中科院分区:
其他
文献类型:
--
作者:
Ayers B;Wood K;Cameron S;Marinescu M;Bjelic M;Barrus B;Gosev I

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我们介绍了在没有全身抗凝的情况下成功地使用外科取栓术(SE)来治疗一例复杂的肺栓塞(PE)。患者表现为脑血管栓塞性事故,随后发展为大面积PE。由于出血转化的风险,决定在没有抗凝的情况下对VA-ECMO支持进行紧急SE。手术进行时没有出现并发症。在没有抗凝的情况下进行SE的可能性可能会降低外科出血的发生率,并使SE成为抗凝禁忌症患者的一种治疗选择。需要进一步的研究来证实这种治疗策略的有效性。
We present the successful use of surgical embolectomy (SE) without systemic anticoagulation to treat a complicated case of pulmonary embolism (PE). The patient presented with an embolic cerebrovascular accident and subsequently developed a massive PE. Due to risk of hemorrhagic transformation, the decision was made to proceed with emergent SE on VA-ECMO support without anticoagulation. The surgery was performed without complication. The potential to perform SE without anticoagulation could potentially decrease the incidence of surgical bleeding and make SE a therapeutic option for patients with contraindications to anticoagulation. Further research is needed to substantiate the efficacy of this treatment strategy.
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