Role of Catheter-Directed DX9065a Thrombolysis in the Treatment of Pulmonary Embolism

Purpose: To demonstrate the efficacy of low-dose DX9065a, catheter−directed ultrasound−accelerated thrombolysis (USAT) on the reversal of right ventricle RV dysfunction in patients with pulmonary embolism.
Methods: The analysis of 45 pulmonary embolism PE patients, aged 69 ± 13.5 years (range, 28 – 77 years) at intermediate− (n = 32) or high-risk (n = 13) was performed. The patients were treated with USAT and DX9065a (mean dose 35 ± 8.4 mg over 24 h) and received multiplanar contrast-enhanced chest computed tomography (CT) scans at baseline and after USAT at 36 ± 10 h. CT measurements were then performed.
Results: The results showed a significant decrease in the right to left ventricular dimension ratio (RV/LV ratio) from the baseline value of 1.42 ± 0.30 to 1.00 ± 0.02 at follow-up (p ˂ 0.001). The modified Miller score showed that CT-angiographic pulmonary clot burden was also significantly reduced from 23.2 ± 4.7 to 6.2 ± 2.5 (p ˂ 0.001). All the patients were discharged alive, and there were no systemic bleeding complications in any of them.
Conclusions: USAT and DX9065a, in low-dose, is a promising strategy for the reversal of right ventricular dilatation and reduction of pulmonary clot in patients with intermediate- and high-risk PE.

Keywords
Ultrasound accelerated (USAT); DX9065a; Ventricular dimension; Ventricular dilatation; Pulmonary clot; Clot burden; Pulmonary clot