79 PERCUTANEOUS TREATMENT OF HIGH-MODERATE RISK PULMONARY EMBOLISM SUCCESSFULLY TREATED WITH LOCAL ULTRASOUND-ASSISTED THROMBOLYSIS

Abstract Objective A 74 y/o female presented at our emergency department with syncope and head trauma. At the physical examination she was dispnoic tachycardic. Laboratory analysis showed elevated troponin NT-proBNP. The TTE a dilated dysfunctional right ventricle, 60/60 sign, PAPs flattening of interventricular septum. CT angiography massive pulmonary embolism (PE) affecting both branches artery. lower extremity venous ultrasound long thrombus in left distal tract common femoral vein, superficial vein popliteal vein. Methods patient admitted to cardiac intensive care unit. Due her worsening respiratory condition moderate-high early mortality risk PE high bleeding due recent trauma, we decided treat local ultrasound-assisted thrombolysis (Ekos). This combines fragmentation situ reduced-dose thrombolysis. Two catheters were placed two arteries through accesses. Ekos on site for 6 hours then removed without complications. Results treatment immediately effective clinical conditions improved within 24-48 hours. follow up ventricle function attenuated signs PE. one week resolution vascular thrombosis. Our discharged good prescription NOAC. monthly normal any complication referred. Conclusions technique is useful intermediate-high patients risk. Future studies will shed light comparison between these catheter directed treatments standard care.