Efficacy and safety outcomes of ultrasound assisted thrombolysis versus standard catheter direct thrombolysis in patients with submassive or massive pulmonary embolism: an updated meta-analysis

Abstract Background The use of catheter-based thrombolysis in comparison to systemic thrombolytics has emerged as a potentially lifesaving therapy for patients with sub massive or pulmonary embolism (PE). addition ultrasound waves accelerate lytic dispersion assisted (USAT) been proposed improve outcomes compared standard catheter-directed (SCDT). These two modalities have small studies, but larger population data on the these therapies is still lacking. Purpose To assess efficacy and safety USAT versus SCDT submassive embolism. Methods A review electronic databases (PubMed, Scopus, Embase, Cochrane) was performed using keywords USAT, PE studies were included if between types therapies. Efficacy that evaluated reduction right ventricle/left ventricle ratio (RV/LV ratio), artery systolic pressure (PASP) Miller score. Safety major bleeding, mortality length ICU stay. Standardized mean differences (SMD) 95% confidence intervals (CI) calculated continuous variables. Risk (RR) CI reported dichotomous variables random effects model comprehensive meta-analysis RevMan 5.4.1 softwares. Results Six total 381 (USAT n=204; n=177) included. No statistical difference over noted degree RV/LV (SMD: −0.507; CI: −1.386–0.373; p>0.05; I2=92%), PASP 0.037; −0.404–0.478; I2=59%), score 0.303; −0.481– 1.087; I2=82%). also not statistically different similar rates bleeding (RR: 1.44; 0.54–3.85; I2=4%), 1.46; 0.35–6.05; I2=0%) stay −0.01; −0.29–0.27; I2=31%) both treatment groups. Conclusion Our suggest despite technological advancement there no additional benefit terms safety. Further are warranted procedures investigating financial clinical real world practice. Funding Acknowledgement Type funding sources: None.