Massive pulmonary embolism: percutaneous mechanical thrombectomy during cardiopulmonary resuscitation.
Seven patients with massive pulmonary embolism (PE) causing cardiac arrest underwent percutaneous mechanical thrombectomy (PMT) with Hydrolyser and Oasis catheters during cardiopulmonary resuscitation (CPR). Three received adjunctive recombinant tissue plasminogen activator. Thrombectomy was successful in restoring pulmonary perfusion in six patients (85.7%). One patient died of cardiac arrest. Systolic pulmonary pressure decreased after thrombectomy from a median of 73 mm Hg (range, 63-90 mm Hg) to 42 mm Hg (range, 32-81 mm Hg; P < .05). There was one groin hematoma that required blood transfusion. In conclusion, massive PE causing cardiac arrest can be treated with PMT simultaneously with CPR maneuvers to rapidly revert circulatory collapse, with restoration of pulmonary circulation. Larger series are needed to validate this method.
Fava
Mario
M
Department of Interventional Radiology, P. Universidad Catolica de Chile, Marcoleta #367, Santiago, Chile. fava@med.puc.cl
Loyola
Soledad
S
Bertoni
Hernán
H
Dougnac
Alberto
A
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D002404:Catheterization; D003131:Combined Modality Therapy; D005471:Fluoroscopy; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator