Abstract
Anticoagulant and thrombolytic therapies are a mainstay in the management of acute pulmonary embolism (PE), especially when hemodynamic compromise is present. However, systemic drugs cannot achieve timely and effective treatment of acute PE in all patients. In such a setting, mechanical removal of thrombus from the pulmonary circulation holds the promise of significant clinical benefits, although it remains untested. We report early and long-term outcome of patients with massive or submassive acute PE treated with rheolytic thrombectomy by means of the 6Fr Xpeedior AngioJet device at our institution. Three main groups were defined pre hoc: subjects with severe (i.e., shock), moderate, or mild hemodynamic compromise. Technical and procedural successes, obstruction, perfusion and Miller indexes, and clinical events were appraised. In total 25 patients were treated with thrombectomy (8 in severe, 12 in moderate, and 5 in mild hemodynamic compromise). Technical and procedural successes were obtained in all patients, as confirmed by the significant improvement in obstruction, perfusion and Miller indexes overall, and in each subgroup (all p values <0.001). Improvement in obstruction, perfusion, and Miller indexes at the end of the p...Continue Reading
References
Feb 1, 1988·Circulation·M VerstraeteC G Olsson
Feb 1, 1988·Chest·K V LeeperP D Stein
Jul 1, 1971·British Heart Journal·G A MillerM Honey
Aug 23, 2000·European Heart Journal
Aug 13, 2002·Journal of Vascular and Interventional Radiology : JVIR·Stefan Müller-HülsbeckMartin Heller
Dec 5, 2003·Journal of Vascular and Interventional Radiology : JVIR·Phillip T ZeniDavid W Peeler
Apr 13, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Dimitris SiablisGeorge Hahalis
Aug 25, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Jürgen BiedererStefan Müller-Hülsbeck
Jan 31, 2007·The American Journal of Cardiology·Elias SkafPaul D Stein
Apr 11, 2007·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Manish S Chauhan, Akio Kawamura
Citations
Nov 16, 2010·Cardiovascular and Interventional Radiology·Richard C HershbergerKrishna Mannava
Nov 12, 2010·Cardiovascular and Interventional Radiology·R López-BenítezP J Hallscheidt
Dec 19, 2008·Nature Clinical Practice. Nephrology·Ramnath DukkipatiJanine Vintch
Feb 12, 2010·Respirology : Official Journal of the Asian Pacific Society of Respirology·Mateo Porres-AguilarEmilio Gonzalez-Ayala
Mar 2, 2010·BMC Cardiovascular Disorders·Umesh U TamhaneHitinder S Gurm
May 21, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiro TsujiMasaaki Ito
Feb 10, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Dabit ArzamendiSerge Doucet
May 18, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Robert F BonviniMarc Righini
Jul 8, 2014·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Rita FariaVasco Gama
Feb 15, 2012·Chest·Clive KearonSusan R Kahn
Dec 24, 2011·Journal of Vascular and Interventional Radiology : JVIR·William T Kuo
Nov 16, 2011·Critical Care Clinics·Victor F Tapson
May 10, 2011·Annals of Vascular Surgery·Tze-Woei TanDucksoo Kim
Nov 5, 2010·Clinics in Chest Medicine·Victor F Tapson
Mar 17, 2010·Progress in Cardiovascular Diseases·Thomas M Todoran, Piotr Sobieszczyk
Oct 31, 2009·Journal of Vascular and Interventional Radiology : JVIR·William T KuoLawrence V Hofmann
Nov 6, 2008·Current Problems in Surgery·Thomas W WakefieldAnthony J Comerota
Nov 1, 2008·Journal of Interventional Cardiology·Christian SpiesClifford J Kavinsky
Feb 24, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Tania ChechiMassimo Margheri
Aug 9, 2011·Journal of Thrombosis and Haemostasis : JTH·S VanniS Grifoni
Feb 20, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·George T NicholsonRobert Vincent
Jul 29, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Gregory A FlemingThomas Doyle
Dec 20, 2014·Journal of Vascular Surgery·Efthymios D Avgerinos, Rabih A Chaer
Oct 1, 2016·Technology and Health Care : Official Journal of the European Society for Engineering and Medicine·Jianming GuoXixiang Gao
Oct 9, 2012·Perfusion·C-H KoR Qasabian
Oct 2, 2009·Perfusion·Kevin E GriffithJonathan Haft
May 23, 2014·Journal of Korean Medical Science·Min Ku ChonKook Jin Chun
Jul 28, 2009·Journal of Thrombosis and Haemostasis : JTH·S Z Goldhaber
Sep 21, 2010·Current Opinion in Cardiology·Nicolas Meneveau
Jun 10, 2010·Expert Review of Cardiovascular Therapy·Licheng LeeChristian Spies
Apr 4, 2019·Herz·N GauchelD Duerschmied
Aug 30, 2017·Frontiers in Pediatrics·Ahmar Urooj ZaidiMadhvi Rajpurkar
Oct 19, 2012·Current Opinion in Cardiology·Victor F Tapson
Nov 28, 2020·Acta Anaesthesiologica Scandinavica·Freyr EinarssonChristian Rylander
Sep 15, 2020·Annals of Vascular Surgery·L Di StefanoR Pulli
Nov 19, 2009·Vascular·Peter H LinPanagiotis Kougias
Aug 31, 2020·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Kun LiShuiting Zhai