title: Percutaneous aspiration thrombectomy in treatment of massive pulmonary embolism.
abstract: BACKGROUND
  Pulmonary embolism (PE) associated with haemodynamic instability has exceedingly high mortality. We describe our experience using percutaneous mechanical thrombectomy (PMT) in patients with massive PE and right ventricle dysfunction.
  
  
  METHODS
  Sixteen patients (11 males and five females; mean age, 55.7 ± 8.3 years) with massive PE were treated with PMT. A percutaneous Aspiration Device (8 French Aspirex® aspiration thrombectomy catheter, Straub Medical, Switzerland) was used in all patients. Clinical outcomes, right ventricle and pulmonary artery pressures (PAP), thrombus clearance and complications were evaluated.
  
  
  RESULTS
  Treatment of 16 patients resulted in complete thrombus clearance (≥ 90%), in 87.5% of the patients and near-complete (50%-90%) clearance in 6.3%. Measurements before and after treatment showed a decrease in PAP (73 ± 11 mm Hg to 34 ± 8 mm Hg, P<.001). The RV/LV ratio decreased from 1.32 ± 0.15 to 0.84 ± 0.13 at follow-up (P<.001). One patient died from refractory shock. No cardiovascular deaths or recurrent PE were documented during clinical follow-up but one patient demonstrated evidence of mild cor pulmonale.
  
  
  CONCLUSIONS
  This study demonstrates safety and effectiveness of percutaneous mechanical aspiration thrombectomy in patients with massive PE with a large thrombus burden.
authors: Department of Pulmonary Medicine, Medical Park Gebze Hospital, Istanbul, Turkey.
authors: Hulya
authors: H
authors: Bayiz
authors: Department of Cardiovascular Surgery, Medical Park Gebze Hospital, Istanbul, Turkey. Electronic address: mdumantepe@gmail.com.
authors: Mert
authors: M
authors: Dumantepe
authors: Department of Cardiovascular Surgery, Medical Park Gebze Hospital, Istanbul, Turkey.
authors: Burak
authors: B
authors: Teymen
authors: Department of Cardiovascular Surgery, Medical Park Gebze Hospital, Istanbul, Turkey.
authors: Ibrahim
authors: I
authors: Uyar
mesh_terms: D062186:Arterial Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology*; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000601:surgery; D012074:Remission Induction; D017131:Thrombectomy; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery
keywords: Aspiration thrombectomy; Catheter-directed therapy; Pulmonary artery pressure; Pulmonary embolism; Right ventricle disfunction.