Long Term Study Looking at the Effects of Treating Submassive Pulmonary Embolism With Ultra-sound Accelerated Thrombolysis
Long Term Study Looking at the Effects of Treating Submassive Pulmonary Embolism With Ultra-sound Accelerated Thrombolysis
Patients with Submassive Pulmonary Embolism treated with ultra-sound therapy will have an
 improved right ventricular function 72 hours post treatment.
Inclusion Criteria:

 -  Patients with acute (< or = 14 days)symptomatic pulmonary embolism by CT Angiogram of
 the thorax with embolus involving at least one main or lower lobe pulmonary artery and
 RV:LV ratio > 0.9

 Exclusion Criteria:

 -  age > 80

 -  Recent thrombolytic therapy (with in 4 days)

 -  Active bleeding or know bleeding diathesis

 -  Known coagulopathy (including treatment with vitamin K antagonists) INR > 3 and/or PTT
 > 50

 -  Thrombocytopenia (PLT cound < 100,000)

 -  History of any intracranial or intraspinal surgery, trauma or bleed

 -  Intracranial neoplasms, AVM, or aneurysm

 -  Recent (< 1 month) GI bleed

 -  Recent (< 3 months) internal eye surgery or hemorrhagic retinopathy

 -  Recent (< 7 days) major surgery, trauma, or obstetrical delivery

 -  Renal insufficiency with eGFR < 45 ml/min

 -  Known allergy, hypersensitivity, or thrombocytopenia from heparin or tPA

 -  Hemodynamic instability defined as need for cardiopulmonay resuscitation, Systolic BP
 > 90 mm Hg for > 15 min or need for pressor agents to maintain BP > 90.

 -  Severe Hypertension (sustained systolic > 180 mm Hg or diastolic > 90 mm Hg.

 -  Pregnant patients

 -  known right to left shunt

 -  Large (>10 mm)intracardiac thrombus

 -  Use of thrombolytics or glycoprotein IIb/IIIa antangonists within 3 days of inclusion.

 -  Life expectancy < 30 days