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Case Reports
. 2021 Oct;8(5):4318-4321.
doi: 10.1002/ehf2.13571. Epub 2021 Aug 24.

Bail-out treatment of pulmonary embolism using a large-bore aspiration mechanical thrombectomy device

Stefan Stadler  1 , Kurt Debl  1 , Markus Ritzka  2 , Lars Siegfried Maier  1 , Samuel Sossalla  1
Affiliations
Case Reports

Bail-out treatment of pulmonary embolism using a large-bore aspiration mechanical thrombectomy device

Stefan Stadler et al. ESC Heart Fail. 2021 Oct.

Abstract

We report on the first pulmonary embolism treatment via the large-bore aspiration mechanical thrombectomy device (Inari FlowTriever®) outside the USA, in a resuscitated patient on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) suffering from severe and acute right heart failure. In this particular high-risk patient population, where thrombolysis is mostly not applicable, this new technology could be a promising solution as the combination of large-bore thrombus aspiration and extraction successfully removes large emboli. In our case, right ventricular function improved rapidly after the procedure, ECMO could be weaned, and the patient was dismissed 2 weeks after. In summary, we provide a new therapeutic option for the often difficult treatment of pulmonary embolism in high-risk patients on VA-ECMO.

Keywords: FlowTriever; Large-bore aspiration mechanical thrombectomy device; Pulmonary embolism; Veno-arterial ECMO.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
(A) Computed tomography scan of the central pulmonary embolism. (B) Echocardiography of right heart thrombus.
Figure 2
Figure 2
Position of the large lumen catheter (Triever Aspiration Catheter®) in the right lung (A) and of the self‐expanding nitinol mesh disks (FlowTriever Catheter®) in the left lung (B). Clots aspirated with the large‐bore syringe (C).
Figure 3
Figure 3
Echocardiography focusing on the right heart immediately before (A) and after (B) aspiration of the pulmonary embolisms.
See this image and copyright information in PMC

References

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