Successful percutaneous mechanical thrombectomy in a haemodynamically unstable patient with massive pulmonary embolism.
Massive pulmonary embolism with haemodynamic instability has a high mortality. Traditionally these patients are treated with i.v. thrombolytic therapy. When this therapeutic approach is contraindicated, surgical embolectomy and most recently, percutaneous mechanical interventions are alternative treatment options. This case report presents a 73-year-old female with a residual hemiparesis secondary to a meningioma resection 45 days previously, who presented with progressive shortness of breath, accompanied by oppressive chest pain, hypotension, tachycardia and severe hypoxaemia. CT pulmonary angiogram confirmed a massive pulmonary embolism extending into the lobar branches bilaterally. The patient was treated with percutaneous mechanical thrombectomy with excellent haemodynamic and clinical outcomes.
Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah Health Sciences Center/School of Medicine, Salt Lake City, Utah 84132, USA. mateo.aguilar@hsc.utah.edu
Mateo
M
Porres-Aguilar
Oscar C
OC
Munoz
Paola
P
Alvarez
Emilio
E
Gonzalez-Ayala
D000368:Aged; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000601:surgery*; D013610:Tachycardia / Q000503:physiopathology; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome