Effects of percutaneous catheter intervention on pulmonary hemodynamic indexes and safety in elderly patients with acute pulmonary embolism

Objective: To investigate the effects of percutaneous catheter intervention (PCI) on pulmonary hemodynamic indexes and safety in elderly patients with acute pulmonary embolism (APE).

Methods: The retrospective study was performed on 65 elderly APE patients. According to the risk classification of Guidelines for Diagnosis, Treatment and Prevention of Pulmonary Thromboembolism in China, the patients were divided into the medium-high risk group (n=37) and high risk group (n=28). All patients received PCI based on thrombolysis. The clinical efficacy after treatment, and changes of pulmonary hemodynamic indexes and blood gas indexes before and after treatment were compared between the two groups, and the complications and prognosis of patients were recorded.

Results: There was no significant difference in the total effective rate between the two groups after treatment (P>0.05). Compared with before operation, mean pulmonary artery pressure (mPAP), ratio of right/left ventricular end diastolic diameter (RVEDD/LVEDD) and pulmonary vascular resistance (PVR) of the two groups were significantly reduced 12 h after operation, and greater changes were observed in the high risk group (all P<0.05). Compared with before operation, arterial oxygen partial pressure (PaO₂), blood oxygen saturation (SaO₂) and oxygenation index (OI) of the two groups were significantly increased 12 h after operation, and the changes of the high risk group were more obvious (all P<0.05). No significant difference was found in the total incidence of complications between the two groups (P>0.05). The three-month follow-up showed that there was no death in the medium-high risk group and the mortality in the high risk group was 3.08%.

Conclusion: PCI has obvious effects in the treatment of elderly APE. It can obviously improve pulmonary blood flow dynamics and oxygenation dysfunction, especially for high-risk patients, and it has fewer postoperative complications with certain security.