scholarly journals Safety of the Inari FlowTriever device for mechanical thrombectomy in patients with acute submassive and massive pulmonary embolism and contraindication to thrombolysis

2020 ◽  
Vol 4 ◽  
pp. 18
Author(s):  
Michael Markovitz ◽  
Nicholas Lambert ◽  
Lowell Dawson ◽  
Glenn Hoots
Keyword(s):  
Heart Rate ◽  
Pulmonary Embolism ◽  
Oxygen Saturation ◽  
Mechanical Thrombectomy ◽  
Clinical Success ◽  
Retrospective Chart Review ◽  
Massive Pulmonary Embolism ◽  
Percutaneous Mechanical Thrombectomy ◽  
Submassive Pulmonary Embolism ◽  
Anticoagulated Patients

Objectives: This report evaluates the safety of percutaneous mechanical thrombectomy with the Inari FlowTriever System (Inari Medical, Irvine, California) for the treatment of acute massive/submassive pulmonary embolism (PE) specifically in therapeutically anticoagulated patients with contraindication to thrombolysis. Material and Methods: A single-center retrospective chart review was performed on patients with contraindication to thrombolysis and massive/submassive PE who underwent FlowTriever thrombectomy between 2017 and 2019. Primary outcomes included procedure or device-related complications within 30 days of discharge. Secondary outcomes included technical and clinical success defined by improvement in mean pulmonary artery pressure (PAP), oxygen saturation, and heart rate. Results: Thirteen patients with contraindication to thrombolysis received FlowTriever thrombectomy with technical success achieved in all cases. Zero major or minor adverse events, technical complications, delayed procedure-related complications, or deaths within 30 days of hospital discharge occurred. Mean PAP decreased significantly by 19.1% (32.5 ± 13.3 mmHg to 26.3 ± 12.4 mmHg; P = 0.0074, 95% confidence interval (CI) 2.0–10.5 mmHg). Oxygen saturation improved post-procedure (increased 3.9 ± 3.8%; p = 0.0032, 95% CI 1.6– 6.1%) as did heart rate (decreased 22.2 ± 17.0 bpm; P < 0.001, 95% CI 11.9–32.4 bpm). Anticoagulation was maintained throughout every procedure and all patients were closed with purse-string suture only. Conclusion: FlowTriever mechanical thrombectomy appears safe for acute PE in therapeutically anticoagulated patients with contraindications to thrombolytic therapy. These patients may experience immediate hemodynamic improvements similar to those reported in other studies. Further data are needed to prospectively evaluate long-term safety in this population.

scholarly journals MASSIVE PULMONARY EMBOLISM TREATED WITH PERCUTANEOUS MECHANICAL THROMBECTOMY

2021 ◽  
Vol 77 (18) ◽  
pp. 2803
Author(s):  
Radhika Deshpande ◽  
Basma Al-Bast ◽  
Mukul Bhattarai ◽  
Abhishek Kulkarni ◽  
Prashant Jagtap
Keyword(s):  
Pulmonary Embolism ◽  
Mechanical Thrombectomy ◽  
Massive Pulmonary Embolism ◽  
Percutaneous Mechanical Thrombectomy

scholarly journals Endovascular management of massive pulmonary embolism with clot fragmentation and suction

2013 ◽  
Vol 12 (1) ◽  
pp. 49-52
Author(s):  
Sergio Quilici Belczak ◽  
Igor Rafael Sincos ◽  
Ricardo Aun ◽  
Alex Lederman ◽  
Boulanger Mioto Neto ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Mechanical Thrombectomy ◽  
Imaging Study ◽  
Right Ventricular Dysfunction ◽  
Massive Pulmonary Embolism ◽  
Sudden Onset ◽  
Percutaneous Mechanical Thrombectomy ◽  
Limb Edema ◽  
To Receive

Massive pulmonary embolism with right ventricular dysfunction may be treated with thrombolysis, embolectomy, or percutaneous mechanical thrombectomy. This study describes our experience with two patients that had massive pulmonary embolism and were treated with percutaneous mechanical thrombectomy and reports on the mid-term results of this procedure. A 28-year-old man and a 70-year-old woman were diagnosed with deep venous thrombosis and massive pulmonary embolism. They first had lower limb edema followed by sudden onset of dyspnea. Their physical examination revealed edema, tachypnea, chest discomfort and jugular turgescence. Both needed to receive oxygen using a nasal cannula. Doppler ultrasound, echocardiography, and computed tomography angiography were used to establish the diagnoses. Patients underwent percutaneous mechanical thrombectomy using the Aspirex® system (Straub Medical), and their clinical condition and imaging study findings improved substantially. At mid-term follow-up, patient conditions were improving satisfactorily.

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