Hasan TAŞOLAR, Sevgi TAŞOLAR, Hasan PEKDEMİR

AKUT PULMONER EMBOLİ TEDAVİSİNDE PERKÜTAN GİRİŞİMSEL TEKNİKLERE GÜNCEL YAKLAŞIM

Akut pulmoner emboli (PE) pulmoner arter ve/veya dallarının trombüsle tıkanması so- nucu gelişen klinik olarak acil bir durumdur. Klinik şiddeti asemptomatik olmaktan, şok ve ani ölüme kadar uzanan yüksek mortaliteye sahip bir hastalıktır. Akut PEde teda- vi medikal ve embolektomi (cerrahi ya da kateterle) olmak üzere iki ana başlık altında toplanmaktadır. Trombolizin mutlak kontrendike olduğu ya da başarısızlıkla sonuçlandığı yüksek riskli PE hastalarında cerrahi embolektomi veya katater ile girişimsel tedavi uygu- lanması tavsiye edilmektedir. Kateter temelli girişimlerin amacı ise hızlıca pulmoner ar- ter basıncını, sağ ventrikül yüklenmesini ve pulmoner vaskuler direnci azaltmak, sistemik perfüzyonu artırmak ve sağ ventrikül fonksiyonlarını düzeltmektir.

Current Approach to Percutaneous Interventional Techniques in the Treatment of Acute Pulmonary Embolism

Acute pulmonary embolism (PE) which develops as a result of obstruction of pulmonary artery and/or branches with thrombus is a clinically urgent condition. It is a disease of which clinical severity ranging from being asymptomatic to shock and sudden death and has a high mortality. Treatment of acute PE is collected under two main categories as medical therapy and embolectomy (surgical or catheter). Application of the surgical embolectomy or catheter interventional therapy are recommended in patients with high-risk PE when thrombolytic therapy has absolute contraindication or failed. Purposes of catheter-based interventions are to quickly reduce the pulmonary artery and right ventricle pressure and pulmonary vascular resistance, to increase systemic perfusion and to improve function of the right ventricle.

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