OPTALYSE-3D results
Loss of volume in the distal pulmonary vessels has been described as a marker of PE severity. OPTALYSE-3D examined changes in the small vessel volumes in response to treatment with ultrasound-assisted, catheter-directed thrombolysis (USCDT; EKOS), large-bore mechanical thrombectomy (LBMT), or anticoagulation only (AC).
Methods
3D reconstruction using clinical CT data and automated lung segmentation were performed to compute total vascular volume (TBV), small vessel volume (<5mm2, BVsmall) and medium vessel volume (>5mm2 and <20mm2, BVmed). All vascular measures were normalized by total lung volume.
CT based 3D reconstruction of patient undergoing USCDT
More complete visualization of the distal vessels in the yellow box demonstrates reperfusion following USCDT treatment.
Conclusions
- There was an observed increase in both small and medium sized venous vessels volumes following treatment with EKOS
- There was no difference in vessel volume response to the dose of thrombolytic administered; i.e., response was retained in the lower dose OPTALYSE cohorts
- No statistically significant differences in vascular volumes were detected following treatment with LBMT or AC
USCDT
| Vascular measures* | Baseline | Post | p-value |
|---|---|---|---|
| Small size arterial volume | 7.3 [3.6-15.3] | 7.6 [3.4-16.1] | 0.86 |
| Small size venous volume | 4.3 [2.9-10.1] | 7.4 [3.1-11.3] | 0.0009 |
| Medium size arterial volume | 14.6 [10.8-20.0] | 15.7 [11.2-19.2] | 0.54 |
| Medium size venous volume | 8.9 [6.7-12.3] | 10.6 [8.5-13.7] | <0.000 |
* all vascular measures represent ml of vascular volume per liters of lung
