Massive pulmonary embolism: treatment with the rotarex thrombectomy system.
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.
Liu
Sheng
S
Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Shi
Hai-Bin
HB
Gu
Jian-Ping
JP
Yang
Zheng-Qiang
ZQ
Chen
Liang
L
Lou
Wen-Sheng
WS
He
Xu
X
Zhou
Wei-Zhong
WZ
Zhou
Chun-Gao
CG
Zhao
Lin-Bo
LB
Xia
Jin-Guo
JG
Li
Lin-Sun
LS
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
D003287:Contrast Media