Aspiration rotational thrombectomy in treatment of pulmonary embolism

Aspiration thrombectomy with the Aspirex (R) system (Straub Medical, Vilters-Wangs, Switzerland) in the treatment of pulmonary embolism with a high risk of death is an effective and safe treatment method that should be more widely used in the treatment of venous thromboembo-lism. To date, aspiration thrombectomy are limited. In this clinical case, the patient was admitted to the clinic on the 14th day from the onset of symptoms (shortness of breath, disturb at the slightest exercise, cyanosis). About 3 weeks ago, the patient underwent a radical nephrectomy on the left for left kidney cancer. The day before going to the clinic, the patient had a hypotension on the background of the above complaints. Echocardiography revealed pulmonary hypertension of III degree (pulmonary artery pressure 90 mmHg), dilatation of the right heart. Spiral CT with intravenous contrast of the pulmonary artery revealed thrombotic masses in the trunk and lobular branches of the right pulmonary artery. Given the PE with high risk of early death, contraindication to thrombolytic therapy, the patient underwent aspiration thrombectomy from the right pulmonary artery using an Aspirex catheter. Repeated angiopulmonography showed the restore patency of lobular branches and trunk of the right pulmonary artery. The use of aspiration thrombectomy in the treatment of PE give possibility to restore the patency of pulmonary artery with minimal risk of bleeding. The use of this method of treatment requires further research to form conclusions based on evidence-based medicine.