Percutaneous aspiration thrombectomy in treatment of massive pulmonary embolism.

Abstract

BACKGROUND:

Pulmonary embolism (PE) associated with haemodynamic instability has exceedingly high mortality. We describe our experience using percutaneous mechanical thrombectomy (PMT) in patients with massive PE and right ventricle dysfunction.

METHODS:

Sixteen patients (11 males and five females; mean age, 55.7 ± 8.3 years) with massive PE were treated with PMT. A percutaneous Aspiration Device (8 French Aspirex® aspiration thrombectomy catheter, Straub Medical, Switzerland) was used in all patients. Clinical outcomes, right ventricle and pulmonary artery pressures (PAP), thrombus clearance and complications were evaluated.

RESULTS:

Treatment of 16 patients resulted in complete thrombus clearance (≥ 90%), in 87.5% of the patients and near-complete (50%-90%) clearance in 6.3%. Measurements before and after treatment showed a decrease in PAP (73 ± 11 mm Hg to 34 ± 8 mm Hg, P<.001). The RV/LV ratio decreased from 1.32 ± 0.15 to 0.84 ± 0.13 at follow-up (P<.001). One patient died from refractory shock. No cardiovascular deaths or recurrent PE were documented during clinical follow-up but one patient demonstrated evidence of mild cor pulmonale.

CONCLUSIONS:

This study demonstrates safety and effectiveness of percutaneous mechanical aspiration thrombectomy in patients with massive PE with a large thrombus burden.

• Authors: Hulya Bayiz, Mert Dumantepe, Burak Teymen, Ibrahim Uyar
• Journal: Heart, lung & circulation (Heart Lung Circ) Vol. 24 Issue 1 Pg. 46-54 (Jan 2015) ISSN: 1444-2892 [Electronic] Australia
• PMID: 25060976 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Topics

• Arterial Pressure
• Female
• Humans
• Male
• Middle Aged
• Pulmonary Artery (physiopathology)
• Pulmonary Embolism (physiopathology, surgery)
• Remission Induction
• Thrombectomy
• Ventricular Dysfunction, Left (physiopathology, surgery)