{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:29:10Z","timestamp":1777915750486,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T00:00:00Z","timestamp":1579219200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the efficacy of protocolized use of catheter-directed thrombolysis and echocardiography in submassive pulmonary embolism patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective study at a single institution of 28 patients that presented with submassive pulmonary embolism from July 2016 to September 2019 was performed. All patients were diagnosed using chest computed tomography demonstrating a pulmonary embolism and abnormal right ventricular to left ventricular ratio. Patients with severe right heart dysfunction (right ventricular to left ventricular ratio \u2a7e1.4) were protocolized to receive catheter-directed thrombolysis via EkoSonic catheters (EKOS Corporation, Bothell, WA, United States). Transthoracic echocardiogram was performed after 24\u2009hours to assess right ventricular function and determine the need to continue thrombolysis. Patients after discharge then received follow-up echocardiograms at 6\u2009weeks to determine new post-treatment baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean patient age was 54.6\u2009years, mean body mass index was 35.0, and mean right ventricular to left ventricular ratio on admission computed tomography imaging was 1.70. Interval mean right ventricular to left ventricular ratio on echocardiography during thrombolysis therapy was 1.01 (p\u2009&lt;\u20090.00001). Patients were tachycardic on admission (mean heart rate 102.2 beats per minute) with improvement by completion of thrombolysis (mean heart rate 72.9 beats per minute) (p\u2009&lt;\u20090.00001). There was a 0% incidence of periprocedural complications. Overall 30-day complication rate was 7.1% (n\u2009=\u20091 arrhythmia, n\u2009=\u20091 delayed intracranial hemorrhage). At 6-week follow-up, 91% of the patients who received echocardiography had normal right ventricular function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This retrospective study demonstrates the effectiveness of protocolized use of catheter-directed thrombolysis and echocardiography in reversing severe right heart dysfunction in submassive pulmonary embolism patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0267659119896891","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T03:39:37Z","timestamp":1579232377000},"page":"641-648","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Protocolized use of catheter-directed thrombolysis and echocardiography is highly effective in reversing acute right heart dysfunction in severe submassive pulmonary embolism patients"],"prefix":"10.1177","volume":"35","author":[{"given":"Sundeep","family":"Guliani","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"},{"name":"Division of Vascular Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"},{"name":"Department of Critical Care, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3748-1568","authenticated-orcid":false,"given":"Jaideep","family":"Das Gupta","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Osofsky","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Marek","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"},{"name":"Division of Vascular Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Ali","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"},{"name":"Division of Vascular Surgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Marinaro","sequence":"additional","affiliation":[{"name":"Department of Critical Care, School of Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,1,17]]},"reference":[{"key":"bibr1-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.841403"},{"key":"bibr2-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn310"},{"key":"bibr3-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00319-7"},{"key":"bibr4-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.592592"},{"key":"bibr5-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.5990"},{"key":"bibr6-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005544"},{"key":"bibr7-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.06.009"},{"key":"bibr8-0267659119896891","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2009.08.002"},{"key":"bibr9-0267659119896891","first-page":"e1492","volume":"9","author":"Mangi 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