Ultrasound Facilitated Catheter Directed Thrombolysis in the Treatment of Acute Pulmonary Embolism: A Case Series of Six Patients

Pulmonary embolism (PE) is a potentially fatal cardiovascular emergency for which catheter-directed thrombolysis has emerged as an alternative therapy in cases where systemic thrombolysis is contraindicated, particularly when assisted by ultrasound (US-CDT).We present here the clinical characteristics, management, and outcomes of six patients with intermediate-high or high-risk PE treated with US-CDT in a tertiary care center.All patients were diagnosed based on CT pulmonary angiography and echocardiography findings and underwent ultrasound-assisted thrombolysis with EKOS catheters.Demographic, clinical, and hemodynamic data were collected, and outcomes were assessed based on echocardiographic parameters and clinical recovery.All patients presented with hemodynamic compromise and right ventricular dysfunction.US-CDT resulted in improvements in pulmonary artery pressures, right ventricular size and function, and oxygenation indices.No major bleeding complications occurred.US-CDT can be considered a safe and effective option in acute PE patients in whom systemic thrombolysis is contraindicated.Further studies are needed to evaluate longterm outcomes and improve patient selection.