Manual aspiration thrombectomy with a standard PTCA guiding catheter for treatment of acute massive pulmonary thromboembolism.
OBJECTIVE
To evaluate the efficacy and safety of percutaneous manual aspiration thrombectomy for the treatment of acute massive pulmonary thromboembolism with hemodynamic impairment.


METHODS
Over a period of 6 years and 9 months, 15 patients with hemodynamic impairment (4 men, 11 women; aged 27-79 years) were treated by manual clot aspiration with a standard, large-lumen percutaneous transluminal coronary angioplasty (PTCA) guiding catheter.


RESULTS
After treatment, angiography demonstrated improvement of pulmonary perfusion in all patients (mean Miller score: before treatment 18.9, after treatment 12.1; P < 0.01). Mean pulmonary arterial pressure decreased from 29.6 to 22.5 mmHg (P < 0.01). The mean treatment time was 114.2 min. All of the patients survived and their clinical status improved. No patient had any significant complication.


CONCLUSIONS
Percutaneous manual aspiration thrombectomy with a standard 8 Fr PTCA guiding catheter achieved rapid, safe improvement of the hemodynamic situation in cases of acute massive pulmonary thromboembolism, with low cost both in terms of time and money.
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Hiroyuki
H
Tajima
Satoru
S
Murata
Tatsuo
T
Kumazaki
Ken
K
Nakazawa
Hiroshi
H
Kawamata
Tsuyoshi
T
Fukunaga
Takeshi
T
Yamamoto
Keiji
K
Tanaka
Teruo
T
Takano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D002404:Catheterization / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013396:Suction; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome