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Embolia Polmonare Acuta: Terapia medica, interventistica e chirurgica Loris Roncon Rovigo

Firenze 5 Novenbre 2010. Embolia Polmonare Acuta: Terapia medica, interventistica e chirurgica Loris Roncon Rovigo. Heart 2010; 96:1418-1424. PE Treatmen t :Begin with anticolagulatio;Consider advanced therapy for high risk patients Goldhaber.

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Embolia Polmonare Acuta: Terapia medica, interventistica e chirurgica Loris Roncon Rovigo

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  1. Firenze 5 Novenbre 2010 Embolia Polmonare Acuta: Terapia medica, interventistica e chirurgica Loris Roncon Rovigo

  2. Heart 2010; 96:1418-1424

  3. PE Treatment :Begin with anticolagulatio;Consider advanced therapy for high risk patients Goldhaber

  4. Kostantinides S: N Engl J Med 2008;359:2804-13

  5. EMBOLIA POLMONARE A RISCHIO INTERMEDIO: TROMBOLISI

  6. EMBOLIA POLMONARE A RISCHIO INTERMEDIO: TROMBOLISI

  7. EMBOLIA POLMONARE A RISCHIO INTERMEDIO: TROMBOLISI

  8. EMBOLIA POLMONARE A BASSO RISCHIO

  9. EMBOLIA POLMONARE AD ALTO RISCHIO • Disponibilità sala operatoria • Accesso • Tempi trasp Mortalità 20-50% -età -durata dei sintomi - rianimazione pre int. -n°episodi di E.P. • Controindicazioni assolute alla trombolisi • Inefficacia della trombolisi • Associata al trombolitico?

  10. Terapia Eparinica PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%) TAO in corso 32 (3.2%) Profilassi con eparina 149 (14.6%)

  11. PZ1024 137 (13.4%) 537 (52.4%) 193 338 (33.4%)

  12. Terapia Eparinica PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%)

  13. Terapia Eparinica PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%) • Pz con neoplasia 230 (22.5 %) • ingresso per EP 178 (17.5%) • Diagnosi • durante ricovero per EP 52(5%)

  14. Trombolisi PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%) PZ trattati con trombolisi tot. 126

  15. Trombolisi PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%)

  16. Terapia complicanze Complicanze emorragiche • Emorragie intracraniche 0.6% (6 pz) • trombolisi 2.4 % (3/126pz) • eparina (enoxaparina) 0.4% (3/981 pz) • trombolisi 2.4 % (3/126pz) • tutti con E.P. rischio intermedio • fascia di età : 1 - 61-70 a. • 2 - 81-90 a. • mortali 2 PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%)

  17. Terapia • Embolia polmonare: altre terapie • Chirugica 0.1% (1) • Trombectomia percutanea 1.2% (12) • Alto rischio 41.6% (5) • Rischio Intermedio 58.4% (7) PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%)

  18. Terapia • Embolia polmonare: altre terapie • Filtro cavale 4.2% (43 pz) • filtro cavale + trombo flottante 2 pz PZ 1024 137 (13.4%) 537 (52.4%) 338 (33.4%)

  19. Terapia

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