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CASE REPORT article

Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1444636

Successful Pharmaco-Invasive Approach Using a Lower Alteplase Dose and VA-ECMO Support in High-Risk Pulmonary Embolism: Case Report

Provisionally accepted
Paola Gutierrez-Gallegos Paola Gutierrez-Gallegos Vicente Jimenez-Franco Vicente Jimenez-Franco Carlos Jerjes-Sanchez Carlos Jerjes-Sanchez *Renata Quevedo-Salazar Renata Quevedo-Salazar Jahir Rodriguez-Rivera Jahir Rodriguez-Rivera Enrique Paredes-Gutierrez Enrique Paredes-Gutierrez Daniel Lira-Lozano Daniel Lira-Lozano Juan Quintanilla-Gutierrez Juan Quintanilla-Gutierrez Rene Gomez-Gutierrez Rene Gomez-Gutierrez Erasmo De La Peña Erasmo De La Peña Guillermo Torre-Amione Guillermo Torre-Amione
  • Escuela de Medicina y Ciencias de la Salud Tec Salud, Tecnológico de Monterrey, Monterrey, Mexico

The final, formatted version of the article will be published soon.

    Despite the elevated mortality rates associated with high-risk pulmonary embolism (PE), this condition remains understudied. Data regarding the effectiveness and safety of invasive therapies such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) in this patient population remains controversial. Here, we present the case of a 61-year-old male with high-risk PE associated with refractory cardiac arrest and cardiogenic shock who underwent a combination of extracorporeal cardiopulmonary resuscitation with VA-ECMO and pharmacoinvasive therapy (mechanical thrombi fragmentation plus lower alteplase dose), resulting in successful pulmonary reperfusion. After a prolonged in-hospital stay, the patient was discharged in stable condition.

    Keywords: High-risk pulmonary embolism, Cardiac arrest, thrombolysis, extracorporeal life-support, ECMO

    Received: 06 Jun 2024; Accepted: 10 Jul 2024.

    Copyright: © 2024 Gutierrez-Gallegos, Jimenez-Franco, Jerjes-Sanchez, Quevedo-Salazar, Rodriguez-Rivera, Paredes-Gutierrez, Lira-Lozano, Quintanilla-Gutierrez, Gomez-Gutierrez, De La Peña and Torre-Amione. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carlos Jerjes-Sanchez, Escuela de Medicina y Ciencias de la Salud Tec Salud, Tecnológico de Monterrey, Monterrey, Mexico

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