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Case Reports in Cardiology
Volume 2016, Article ID 4167397, 5 pages
http://dx.doi.org/10.1155/2016/4167397
Case Report

Ultrasound Assisted Catheter Directed Thrombolysis in the Management of a Right Atrial Thrombus: A New Weapon in the Armamentarium?

1Internal Medicine Department, Detroit Medical Center, Wayne State University, Detroit, MI, USA
2Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA

Received 25 May 2016; Revised 28 July 2016; Accepted 10 August 2016

Academic Editor: Ertuğurul Ercan

Copyright © 2016 Mohamed Shokr et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Catheter related thrombosis (CRT) is a commonly encountered entity fraught with substantial risk for mortality secondary to various complications including pulmonary embolism (PE), tricuspid regurgitation, endocarditis, right sided heart failure, and cardiogenic and septic shock. CRT carries a mortality rate of 18% in hemodialysis patients and more than 40% in nonhemodialysis patients. Management strategies include systemic anticoagulation, systemic thrombolysis, surgical evacuation, and percutaneous retrieval with no established guidelines. Ultrasound assisted catheter directed thrombolysis emerges as promising modality with a relatively lower risk of hemorrhage compared to systemic thrombolysis. We report a case of a 75-year-old man with dialysis catheter related thrombosis without PE for which ultrasound assisted catheter directed thrombolysis was used successfully as an alternative therapy.