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Mechanical thrombectomy for early treatment of massive pulmonary embolism.
- Source :
-
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2003 May-Jun; Vol. 26 (3), pp. 246-50. - Publication Year :
- 2003
-
Abstract
- We report our technique and results of percutaneous mechanical thrombectomy in a consecutive series of eight patients with massive PE. We also discuss the possible role of mechanical PE thrombectomy. Eight consecutive patients with acute massive PE, with or without hemodynamic impairment, were treated with mechanical thrombectomy. We used a modified 7-fr hydrolyzer catheter. The treatment was combined with systemic fibrinolysis. From the logistic and technical point we encountered no problems. All patients showed significant improvement while still in the angiography suite. There were no bleeding complications and no other events related to the procedure. Despite the clinical improvement, one patient died shortly after the procedure from cardiac failure. In all patients there was an acute increase in PO2 to normal values. Only a mean of about 50% of all local thrombus could be removed (range 30-80%). The mean PAP pre-intervention decreased only minimally from 42.5 mmHg to 36.3 mmHg post-intervention (not significant). In three patients, the PAP continues to remain high at follow-up. The most important feature of mechanical thrombectomy for massive PE is the immediate improvement of the cardiac output, PO2, and clinical situation, overcoming the first critical hours after massive PE. The amount of thrombus reduction seems not to be an important parameter.
- Subjects :
- Adult
Aged
Equipment Design
Female
Follow-Up Studies
Humans
Male
Middle Aged
Oxygen Consumption physiology
Postoperative Complications etiology
Postoperative Complications mortality
Postoperative Complications physiopathology
Pulmonary Artery physiopathology
Pulmonary Artery surgery
Pulmonary Embolism mortality
Pulmonary Embolism physiopathology
Pulmonary Wedge Pressure physiology
Survival Analysis
Time Factors
Treatment Outcome
Pulmonary Embolism surgery
Thrombectomy
Subjects
Details
- Language :
- English
- ISSN :
- 0174-1551
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 14562972
- Full Text :
- https://doi.org/10.1007/s00270-003-1984-7