Ultrasound‑enhanced, catheter‑directed thrombolysis for pulmonary embolism

The condition

A pulmonary embolism is a blockage in the pulmonary artery, which is the blood vessel that carries blood from the heart to the lungs. The blockage is usually caused by a blood clot that has come loose and travelled from one of the deep veins in the leg, thigh, pelvis or arm.

Symptoms of pulmonary embolism can include chest pain, shortness of breath, and coughing up blood. Severe pulmonary embolism can be life‑threatening. Some people are at risk of developing pulmonary embolism, for example after surgery or if they can't move.

The usual treatments for pulmonary embolism are anticoagulant drugs (usually warfarin or heparin), which thin the blood to stop it clotting further. There are also methods that physically break up the clot (mechanical thrombectomy) or dissolve the clot with drugs (catheter‑directed thrombolysis) using a tube inserted into the blocked artery. Thrombolysis carries a risk of serious complications. If pulmonary embolism is life‑threatening, the clot may be removed surgically.

NICE has looked at using ultrasound-enhanced, catheter-directed thrombolysis as another treatment option.

NHS Choices (www.nhs.uk) and NICE's information for the public about venous thromboembolic diseases may be a good place to find out more.