title: Massive pulmonary embolism: treatment with the rotarex thrombectomy system.
abstract: This study was designed to evaluate the efficacy and safety of percutaneous mechanical thrombectomy (PMT) for acute massive pulmonary embolism (PE). Fourteen patients (8 men, 6 women) with a mean age of 55.4 (range, 38-71) years with acute massive PE were initially diagnosed by computed tomography (CT) and confirmed by pulmonary angiography. All patients presented with acute PE symptoms and hemodynamic compromise. Each patient was treated with Straub Rotarex thrombectomy device and five patients received additional thrombolysis. Technique success and clinical improvement were achieved in all patients without major complications. The mean pulmonary artery pressure (PAP) decreased from 37.6 ± 6.6 to 29 ± 6.4 mmHg (P < 0.01) after PMT. Partial arterial pressures of O(2) (PaO(2)) increased from 61.1 ± 9.2 to 88 ± 5.1 mmHg (P < 0.01). The Miller index was 0.67 ± 0.11 and 0.37 ± 0.13 (P < 0.01), respectively, before and after PMT (P < 0.01). Eleven patients had no recurrence of PE on a mean follow-up of 28.3 months, whereas the other three patients were lost to follow-up. The preliminary experience in our series suggests that the Straub Rotarex thrombectomy device, which has been utilized in peripheral arteries, also is useful for the treatment of acute massive PE.
authors.affiliation: Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Shi
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Gu
authors.forename: Zheng-Qiang
authors.initials: ZQ
authors.lastname: Yang
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Lou
authors.forename: Xu
authors.initials: X
authors.lastname: He
authors.forename: Wei-Zhong
authors.initials: WZ
authors.lastname: Zhou
authors.forename: Chun-Gao
authors.initials: CG
authors.lastname: Zhou
authors.forename: Lin-Bo
authors.initials: LB
authors.lastname: Zhao
authors.forename: Jin-Guo
authors.initials: JG
authors.lastname: Xia
authors.forename: Lin-Sun
authors.initials: LS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D012189:Retrospective Studies; D017131:Thrombectomy / Q000295:instrumentation*; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media