Inhaled nitric oxide as an adjunct to suction thrombectomy for pulmonary embolism.
Pulmonary suction thrombectomy can be a successful interventional tool in the treatment of pulmonary thromboembolism. Removal of clot burden typically results in prompt recovery of hemodynamic stability and improved oxygenation. However, in rare cases, clot removal does not sufficiently improve the clinical situation. Herein, two patients with massive pulmonary thromboembolism are presented whose condition improved only after they received nitric oxide as an adjunct to pulmonary suction thrombectomy. The treatment with this inhalable vasodilator was based on the hypothesis that prolonged ischemia had induced microcirculatory vasospasm, persistent after removal of the central clot.
Faintuch
Salomão
S
Departments of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue (WCC 308), Boston, Massachusetts 02215, USA.
Lang
Elvira V
EV
Cohen
Robert I
RI
Pinto
Duane S
DS
D000280:Administration, Inhalation; D000328:Adult; D000792:Angiography / Q000379:methods; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000601:surgery*; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
D001993:Bronchodilator Agents; D009569:Nitric Oxide