Combined endovascular interventions for pulmonary embolism at high altitude in Tibet

Background: Managing pulmonary embolism (PE) at extremely high altitudes poses unique challenges due to harsh environmental conditions and limited healthcare resources. Method: This study retrospectively analyzed Tibetan PE patients in the Tibet Autonomous Region of China to evaluate the effectiveness and safety of combined endovascular interventional therapy in high-altitude areas. Results: The average altitude of long-term residence for Tibetan patients was 3,863.4 +/- 317.4 m, with an average age of 62.0 +/- 16.0 years, and the time from computed tomography pulmonary angiography (CTPA) diagnosis to interventional treatment averaged 2.8 +/- 2.2 days. The operation time for these patients was 106.1 +/- 22.2 min, and the intraoperative dose of alteplase used was 23.3 +/- 5.0 mg. All 9 patients reported profound remission of dyspnea and chest pain after endovascular interventions. The heart rate (p < 0.05) and respiratory rate (p < 0.001) of all enrolled patients were significantly decreased, and the peripheral capillary oxygen saturation (SpO2) was significantly increased (p < 0.05) after interventions. No severe complications, such as bleeding, occurred in any patient. Conclusion: This study demonstrated the potential clinical benefits and feasibility of combined endovascular interventional therapy for treating acute PE in extreme high-altitude regions.