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Lung India Official publication of Indian Chest Society  
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 37  |  Issue : 6  |  Page : 485-490

Technical efficiency, short-term clinical results and safety of a large-bore aspiration catheter in acute pulmonary embolism – A retrospective case study


1 Department of Radiology, Section of Vascular and Interventional Radiology; School of Medicine, University of Missouri, Columbia, MO, USA
2 Department of Radiology, Section of Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA
3 Department of Medicine, Division of Infectious diseases; Department of Medicine, Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri, Columbia, MO, USA
4 Department of Medicine, Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri, Columbia, MO, USA
5 Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA

Correspondence Address:
Dr. Ambarish P Bhat
Department of Radiology, Section of Vascular and Interventional Radiology, University Hospital, One Hospital Drive, Columbia, MO 65212
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/lungindia.lungindia_115_20

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Background: Mechanical thrombectomy plays an important role in the management of acute pulmonary embolism (PE), either when rapid clot dissolution is needed or when thrombolytics are contraindicated. We describe our clinical and technical experience with the FlowTriever mechanical thrombectomy device in patients with acute PE. Materials and Methods: A retrospective analysis was performed on all cases of acute PE treated with the FlowTriever device at a single tertiary care hospital system during the trial period (November 2019–January 2020). Technical and clinical results, including complications, are reported. Results: Technical success was achieved in all eight successive cases (seven cases of submassive and 1 case of massive PE). Mean pulmonary artery pressure (MPAP) improved significantly after mechanical thrombectomy (27.8 ± 6.4 mmHg preprocedure; 20.5 ± 3.8 mmHg postprocedure; 7.3 ± 5.2 mmHg decrease after the procedure; P = 0.016). Hemoglobin levels did not change significantly after mechanical thrombectomy (11.8 g/dl ± 3.4 preprocedure; 9.9 g/dl ± 2.1 postprocedure; P = 0.20). Reduction in MPAP was achieved in 88% of cases (7/8) and hypoxia improved in all the nonintubated patients (7/7). Mortality observed in one patient with a massive central PE, was not related to the procedure. No mortality or procedural complications were observed in patients with submassive PE. Conclusions: The positive initial clinical experience and safety profile using the FlowTriever in the treatment of acute PE suggests, it has the potential to fill the unmet needs of a good mechanical thrombectomy device to treat massive and submassive high-risk PE especially when thrombolytics are contraindicated.


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