title: Acute-on-chronic massive pulmonary embolism treated with 3-loop snare.
abstract: A 70-year-old man presented with acute massive pulmonary embolism (PE). His clinical condition deteriorated despite regular heparin and thrombolytic agent treatment, and he eventually developed cardiogenic shock. A thrombus originating from the inferior vena cava was detected and acute-on-chronic embolization resulted, with an unusual clinical course. Aggressive catheter thrombectomy with pigtail rotation failed to fragment the organized thrombus, but it was successfully removed by a 3-loop snare device combined with guiding catheter under percutaneous cardiopulmonary support.
authors.affiliation: Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Taiwan.
authors.forename: Jen Te
authors.initials: JT
authors.lastname: Hsu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakamura
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Funatsu
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Enjoji
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Hori
authors.forename: Chinae
authors.initials: C
authors.lastname: Miyamoto
mesh_terms: D000208:Acute Disease; D000368:Aged; D002406:Catheterization, Peripheral; D002908:Chronic Disease; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin