Percutaneous rheolytic thrombectomy for large pulmonary embolism

A promising treatment option

Manish S. Chauhan, Akio Kawamura

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Pulmonary embolism (PE) is a common cardiovascular disease with significant mortality. Some patients with large PE are not eligible for current treatment options such as thrombolysis or surgical embolectomy. We report our experience of percutaneous rheolytic thrombectomy (PRT) using the AngioJet system combined with adjunctive local thrombolytic therapy and inferior vena cava (IVC) filter placement to treat massive or submassive PE in patients ineligible for current treatment options. Methods and Results: Of the 14 consecutive patients ineligible for thrombolysis or embolectomy treated with PRT, 10 patients had massive PE (6 patients were hypotensive and 4 patients had intractable hypoxemia) and 4 patients had submassive PE. Adjunctive local thrombolysis was performed in 5 patients. An IVC filter was placed in 11 patients. Angiographic success based on Miller score was achieved in 13 patients (92.9%). Procedure success was obtained in 12 patients (85.7%). Procedural mortality occurred in one patient who presented in cardiogenic shock (7.1%) and non-fatal hemoptysis occurred in 1 patient (7.1%). Total in-hospital mortality occurred in 3 patients (21.4%). On a mean follow-up of 9 months, all 11 survivors had noted significant improvement in symptoms without recurrence. Conclusions: Percutaneous rheolytic thrombectomy using the AngioJet may be a treatment option for patients with massive or submassive PE who may not be eligible for thrombolytic therapy or surgical embolectomy.

Original languageEnglish
Pages (from-to)121-128
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume70
Issue number1
DOIs
Publication statusPublished - 2007 Jul 1

Fingerprint

Thrombectomy
Pulmonary Embolism
Embolectomy
Therapeutics
Vena Cava Filters
Thrombolytic Therapy
Cardiogenic Shock
Hemoptysis
Mortality
Hospital Mortality

Keywords

  • AngioJet
  • Embolism
  • Embolization
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Percutaneous rheolytic thrombectomy for large pulmonary embolism : A promising treatment option. / Chauhan, Manish S.; Kawamura, Akio.

In: Catheterization and Cardiovascular Interventions, Vol. 70, No. 1, 01.07.2007, p. 121-128.

Research output: Contribution to journalArticle

@article{417579f5e88745e980789d45c410169b,
title = "Percutaneous rheolytic thrombectomy for large pulmonary embolism: A promising treatment option",
abstract = "Background: Pulmonary embolism (PE) is a common cardiovascular disease with significant mortality. Some patients with large PE are not eligible for current treatment options such as thrombolysis or surgical embolectomy. We report our experience of percutaneous rheolytic thrombectomy (PRT) using the AngioJet system combined with adjunctive local thrombolytic therapy and inferior vena cava (IVC) filter placement to treat massive or submassive PE in patients ineligible for current treatment options. Methods and Results: Of the 14 consecutive patients ineligible for thrombolysis or embolectomy treated with PRT, 10 patients had massive PE (6 patients were hypotensive and 4 patients had intractable hypoxemia) and 4 patients had submassive PE. Adjunctive local thrombolysis was performed in 5 patients. An IVC filter was placed in 11 patients. Angiographic success based on Miller score was achieved in 13 patients (92.9{\%}). Procedure success was obtained in 12 patients (85.7{\%}). Procedural mortality occurred in one patient who presented in cardiogenic shock (7.1{\%}) and non-fatal hemoptysis occurred in 1 patient (7.1{\%}). Total in-hospital mortality occurred in 3 patients (21.4{\%}). On a mean follow-up of 9 months, all 11 survivors had noted significant improvement in symptoms without recurrence. Conclusions: Percutaneous rheolytic thrombectomy using the AngioJet may be a treatment option for patients with massive or submassive PE who may not be eligible for thrombolytic therapy or surgical embolectomy.",
keywords = "AngioJet, Embolism, Embolization, Thrombolysis",
author = "Chauhan, {Manish S.} and Akio Kawamura",
year = "2007",
month = "7",
day = "1",
doi = "10.1002/ccd.20997",
language = "English",
volume = "70",
pages = "121--128",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - Percutaneous rheolytic thrombectomy for large pulmonary embolism

T2 - A promising treatment option

AU - Chauhan, Manish S.

AU - Kawamura, Akio

PY - 2007/7/1

Y1 - 2007/7/1

N2 - Background: Pulmonary embolism (PE) is a common cardiovascular disease with significant mortality. Some patients with large PE are not eligible for current treatment options such as thrombolysis or surgical embolectomy. We report our experience of percutaneous rheolytic thrombectomy (PRT) using the AngioJet system combined with adjunctive local thrombolytic therapy and inferior vena cava (IVC) filter placement to treat massive or submassive PE in patients ineligible for current treatment options. Methods and Results: Of the 14 consecutive patients ineligible for thrombolysis or embolectomy treated with PRT, 10 patients had massive PE (6 patients were hypotensive and 4 patients had intractable hypoxemia) and 4 patients had submassive PE. Adjunctive local thrombolysis was performed in 5 patients. An IVC filter was placed in 11 patients. Angiographic success based on Miller score was achieved in 13 patients (92.9%). Procedure success was obtained in 12 patients (85.7%). Procedural mortality occurred in one patient who presented in cardiogenic shock (7.1%) and non-fatal hemoptysis occurred in 1 patient (7.1%). Total in-hospital mortality occurred in 3 patients (21.4%). On a mean follow-up of 9 months, all 11 survivors had noted significant improvement in symptoms without recurrence. Conclusions: Percutaneous rheolytic thrombectomy using the AngioJet may be a treatment option for patients with massive or submassive PE who may not be eligible for thrombolytic therapy or surgical embolectomy.

AB - Background: Pulmonary embolism (PE) is a common cardiovascular disease with significant mortality. Some patients with large PE are not eligible for current treatment options such as thrombolysis or surgical embolectomy. We report our experience of percutaneous rheolytic thrombectomy (PRT) using the AngioJet system combined with adjunctive local thrombolytic therapy and inferior vena cava (IVC) filter placement to treat massive or submassive PE in patients ineligible for current treatment options. Methods and Results: Of the 14 consecutive patients ineligible for thrombolysis or embolectomy treated with PRT, 10 patients had massive PE (6 patients were hypotensive and 4 patients had intractable hypoxemia) and 4 patients had submassive PE. Adjunctive local thrombolysis was performed in 5 patients. An IVC filter was placed in 11 patients. Angiographic success based on Miller score was achieved in 13 patients (92.9%). Procedure success was obtained in 12 patients (85.7%). Procedural mortality occurred in one patient who presented in cardiogenic shock (7.1%) and non-fatal hemoptysis occurred in 1 patient (7.1%). Total in-hospital mortality occurred in 3 patients (21.4%). On a mean follow-up of 9 months, all 11 survivors had noted significant improvement in symptoms without recurrence. Conclusions: Percutaneous rheolytic thrombectomy using the AngioJet may be a treatment option for patients with massive or submassive PE who may not be eligible for thrombolytic therapy or surgical embolectomy.

KW - AngioJet

KW - Embolism

KW - Embolization

KW - Thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=34447131510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447131510&partnerID=8YFLogxK

U2 - 10.1002/ccd.20997

DO - 10.1002/ccd.20997

M3 - Article

VL - 70

SP - 121

EP - 128

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 1

ER -