title: Rheolytic thrombectomy in patients with massive pulmonary embolism: a report of two cases and review of literature.
abstract: We present two cases of massive pulmonary embolism with persistent systolic hypotension but both have contraindications for thrombolysis. Therefore, rheolytic thrombectomy using AngioJet was performed and immediate haemodynamic improvement was achieved including blood pressure and symptoms. According to guidelines, catheter embolectomy or fragmentation may be considered as alternative to surgical treatment in massive pulmonary embolism patients when thrombolysis is absolutely contraindicated or has failed. Percutaneous catheter-based interventional techniques include thrombus fragmentation, rheolytic thrombectomy, suction thrombectomy and rotational thrombectomy. With the existing literature review and our case, rheolytic thrombectomy for treatment of massive pulmonary embolism using AngioJet achieves a high procedural success rate (approximately 90%) n terms of improvement of haemodynamics, pulmonary perfusion and angiographic result but low complication rate.
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore. chunpongw@gmail.com
authors.forename: Chun Pong
authors.initials: CP
authors.lastname: Wong
authors.forename: Hee Hwa
authors.initials: HH
authors.lastname: Ho
authors.forename: Fahim H
authors.initials: FH
authors.lastname: Jafary
authors.forename: Paul J L
authors.initials: PJ
authors.lastname: Ong
mesh_terms: D000368:Aged; D002404:Catheterization / Q000379:methods; D000075202:Contraindications; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome