Ultrasound-enhanced thrombolysis: EKOS endowave infusion catheter system
Presentation
History of cervical cancer and chest pain. Evidence of acute DVT on ultrasound of legs. Echocardiogram showed pulmonary embolism in PA. No CTA chest, Patient went for direct catheter directed thrombolysis.
Patient Data
- Right IJ porta catheter.
- Left PICC line catheter.
- Right PICC approach EKOS catheter.
Patient had a pulmonary embolus and underwent catheter directed thrombolysis.
Case Discussion
The EKOS catheters have ultrasound transducers within the wire of the catheter which uses ultrasound waves to accelerate the fibrinolytic process and therefore decrease treatment time and decrease the total dose of thrombolytic agent needed which should translate into decreased morbidity and mortality 1.
A prospective multicenter study with 150 patients with acute massive or submassive pulmonary embolism who underwent ultrasound-facilitated, catheter directed, low-dose fibrinolysis showed decreased right ventricular dilatation, decreased pulmonary hypertension, reduced clot burden, and decreased intracranial hemorrhages in these patients. Efficacy outcomes were measured within 48 hours of initiation of fibrinolytic therapy 4. In the case presented, there was also improved cardiac function after administration of tPA via EKOS catheters within 48 hours. Therefore, this case supports the benefits of using EKOS catheters for the administration of fibrinolytics in pulmonary embolism.
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