Acute-on-chronic massive pulmonary embolism treated with 3-loop snare.
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.
Hsu
Jen Te
JT
Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Pu-Tz City, Taiwan.
Nakamura
Shigeru
S
Yamamoto
Ryuji
R
Kobayashi
Tomoko
T
Funatsu
Atsushi
A
Enjoji
Yoshihisa
Y
Mizobuchi
Masahiro
M
Hori
Masaki
M
Miyamoto
Chinae
C
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
D005343:Fibrinolytic Agents; D006493:Heparin