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The Efficacy of Rotational Thrombectomy on the Mortality of Patients with Massive and Submassive Pulmonary Embolism
Author(s) -
Dumantepe Mert,
Teymen Burak,
Akturk Ulku,
Seren Mustafa
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12521
Subject(s) - medicine , thrombus , pulmonary embolism , percutaneous , cardiology , hemodynamics , embolism , pulmonary artery , radiology , surgery
Background Pulmonary embolism (PE) associated with hemodynamic instability has exceedingly high mortality. We describe our experience using percutaneous mechanical thrombectomy (PMT) in patients with massive PE (MPE) and submassive PE (SPE). Methods Thirty‐six patients (16 males and 20 females; mean age, 51.4 ± 6.6 years) with massive and submassive PE were treated with PMT. All patients exhibited acute symptoms and computed tomography evidence of large thrombus burden and evidence of right ventricular (RV) dysfunction and/or failure. An Aspirex® percutaneous aspiration device was used in all patients. Clinical outcomes, hemodynamic recovery, RV and pulmonary artery pressures (PAP), blood gas changes, thrombus clearance, and complications were evaluated. Results Treatment of 36 patients resulted in complete thrombus clearance (≥90%) in 83.3% of the patients (n = 30) and near‐complete (50% to 90%) clearance in 13.8%. Measurements before and after treatment showed a decrease in mean PAP (53 ± 5.8 mmHg versus 25.6 ± 6.3 mmHg in MPE group [p < 0.01] and 46 ± 7.7 versus 22 ± 3.6 in SPE group [p < 0.01]). 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 and submassive PE with a large thrombus burden. doi: 10.1111/jocs.12521 (J Card Surg 2015;30:324–332)