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Mechanical thrombectomy for early treatment of massive pulmonary embolism.

Authors :
Reekers JA
Baarslag HJ
Koolen MG
Van Delden O
van Beek EJ
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.

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