A retrospective review of patients with massive and submassive pulmonary embolism treated with AngioJet rheolytic thrombectomy with decreased complications due to changes in thrombolytic use and procedural modifications

被引:36
作者
Das, Sundeep [1 ]
Das, Nikhil [2 ]
Serota, Harvey [3 ]
Vissa, Sriram [4 ]
机构
[1] St Louis Heart & Vasc, St Louis, MO USA
[2] Univ Miami, Miami, FL USA
[3] St Louis Univ, Div Cardiol, St Louis, MO 63103 USA
[4] DePaul Hosp, Dept Internal Med, St Louis, MO USA
关键词
Thrombolysis; embolism; percutaneous; THROMBOEMBOLISM; THERAPY;
D O I
10.1177/1708538117722728
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objectives A retrospective review of treatment of patients with massive or submassive pulmonary embolism (PE) using AngioJet rheolytic thrombectomy (ART) system with procedural modifications to improve on the previously reported outcomes. Materials and Methods Thirteen patients underwent emergent pulmonary artery thrombectomy for massive and submassive PE using ART with pharmacological and procedural modification, in comparison to prior reports. The modifications included the selective use of the Solent Omni AngioJet device in all subjects, distal contrast angiography via the AngioJet catheter before device activation, and limited short run times. Thrombolytic therapy was not used in any patient. Patients were monitored for short- and long-term outcomes. Long-term clinical follow-up and evaluation for persistent pulmonary hypertension with echocardiography was performed. Results The pharmacological and procedural modifications resulted in a favorable clinical response without any major complications and without any mortality. Procedure-related anemia (mean hemoglobin drop of 0.49g/dl) was the only significant minor complication noted. There were no bleeding complications and no transfusion requirement. On a six-month follow-up, there was no mortality, and there were significant reductions in the pulmonary artery pressures. Conclusion Major and minor complications were reduced compared to prior reports using ART. A modified ART approach towards treatment of high-risk PE appears promising both in terms of efficacy and safety.
引用
收藏
页码:163 / 168
页数:6
相关论文
共 12 条
[1]   Catheter-Based Reperfusion Treatment of Pulmonary Embolism [J].
Engelberger, Rolf P. ;
Kucher, Nils .
CIRCULATION, 2011, 124 (19) :2139-2144
[2]   Predictors of major hemorrhage following fibrinolysis for acute pulmonary embolism [J].
Fiumara, K ;
Kucher, N ;
Fanikos, J ;
Goldhaber, SZ .
AMERICAN JOURNAL OF CARDIOLOGY, 2006, 97 (01) :127-129
[3]   Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER) [J].
Goldhaber, SZ ;
Visani, L ;
De Rosa, M .
LANCET, 1999, 353 (9162) :1386-1389
[4]   Acute Pulmonary Embolism With an Emphasis on an Interventional Approach [J].
Jaber, Wissam A. ;
Fong, Pete P. ;
Weisz, Giora ;
Lattouf, Omar ;
Jenkins, James ;
Rosenfield, Kenneth ;
Rab, Tanveer ;
Ramee, Stephen .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2016, 67 (08) :991-1002
[5]   Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension [J].
Jaff, Michael R. ;
McMurtry, M. Sean ;
Archer, Stephen L. ;
Cushman, Mary ;
Goldenberg, Neil ;
Goldhaber, Samuel Z. ;
Jenkins, J. Stephen ;
Kline, Jeffrey A. ;
Michaels, Andrew D. ;
Thistlethwaite, Patricia ;
Vedantham, Suresh ;
White, R. James ;
Zierler, Brenda K. .
CIRCULATION, 2011, 123 (16) :1788-1830
[6]   Massive pulmonary embolism [J].
Kucher, N ;
Rossi, E ;
De Rosa, M ;
Goldhaber, SZ .
CIRCULATION, 2006, 113 (04) :577-582
[7]   Catheter-directed Therapy for the Treatment of Massive Pulmonary Embolism: Systematic Review and Meta-analysis of Modem Techniques [J].
Kuo, William T. ;
Gould, Michael K. ;
Louie, John D. ;
Rosenberg, Jarrett K. ;
Sze, Daniel Y. ;
Hofmann, Lawrence V. .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2009, 20 (11) :1431-1440
[8]  
LEVINE MN, 1995, CLIN CHEST MED, V16, P321
[9]   Catheter fragmentation of acute massive pulmonary thromboembolism: distal embolisation and pulmonary arterial pressure elevation [J].
Nakazawa, K. ;
Tajima, H. ;
Murata, S. ;
Kumita, S-I ;
Yamamoto, T. ;
Tanaka, K. .
BRITISH JOURNAL OF RADIOLOGY, 2008, 81 (971) :848-854
[10]   The role of pulmonary embolectomy in the treatment of acute pulmonary embolism: a literature review from 1968 to 2008 [J].
Samoukovic, Gordan ;
Malas, Tarek ;
deVarennes, Benoit .
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2010, 11 (03) :265-270