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Novel percutaneous catheter thrombectomy in acute massive pulmonary embolism: Rotational bidirectional thrombectomy (ROBOT)
Author(s) -
Yoshida Masashi,
Inoue Ichiro,
Kawagoe Takuji,
Ishihara Masaharu,
Shimatani Yuji,
Kurisu Satoshi,
Kusano Kengo Fukushima,
Ohe Tohru
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20747
Subject(s) - medicine , thrombolysis , percutaneous , pulmonary embolism , hemodynamics , pulmonary artery , catheter , surgery , cardiology , balloon , radiology , myocardial infarction
Abstract Background : Although thrombolysis is a standard therapy in cases of pulmonary embolism (PE), fatal outcome is often observed. We designed and investigated the efficacy of a novel percutaneous catheter therapy, rotational bidirectional thrombectomy (ROBOT), for PE. Methods and Results : Eighteen patients with acute massive PE (Miller score ≥ 20) were included in this study. We separated them into two groups [group A ( n = 10), thrombolysis; group B ( n = 8): thrombolysis and ROBOT or ROBOT alone]. There was no difference in the hemodynamic indices between the groups at diagnosis. ROBOT was designed to fragment emboli by rotating a regular pigtail catheter. Three deaths occurred in group A because of hemodynamic impairment, but there was no death in group B. One day after treatment, systolic pulmonary artery pressure had decreased from 53 ± 8 to 30 ± 8 mm Hg ( P < 0.05) in group B and from 54 ± 5 to 42 ± 19 mm Hg (NS) in group A. The hospitalization period in group B was shorter than that in group A (17 ± 6 vs. 27 ± 10 days, P < 0.05). Conclusion : ROBOT therapy results in a significant, rapid improvement in the hemodynamic situation and in a better outcome than conventional therapy in patients with acute massive pulmonary embolism. © 2006 Wiley‐Liss, Inc.