We congratulate the authors on their successful study. Although a relatively new method, the catheter-directed ultrasound-accelerated thrombolysis (USAT) was reported in various studies to yield satisfactory results in the treatment of acute pulmonary embolism. As in the present study,1 the effectiveness of the treatment has been evaluated on the basis of the degree of thrombolysis confirmed by computed tomography (CT) in the clot impacted in the pulmonary artery following the therapy. However, Engelhardt et al assessed the right-left ventricular (RV/LV) diameter ratios on CT, detecting a decrease in the former ratio depending on the right ventricular shrinkage due to regression of the right ventricular failure following USAT therapy. Of the patients in whom we performed USAT in our clinic, we noted a dramatic improvement in the symptoms and a decrease in the RV/LV ratio following the procedure in one, although a noncomplete lysis was confirmed on postoperative CT in the pulmonary arterial clot.
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