Yasin Junaid T, Davis Ryan, Saemi Arash, Regunath Hariharan, Krvavac Armin, Saboo Sachin S, Bhat Ambarish P
Department of Radiology, Section of Vascular and Interventional Radiology; School of Medicine, University of Missouri, Columbia, MO, USA.
Department of Radiology, Section of Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA.
Lung India. 2020 Nov-Dec;37(6):485-490. doi: 10.4103/lungindia.lungindia_115_20.
Mechanical thrombectomy plays an important role in the management of acute pulmonary embolism (PE), either when rapid clot dissolution is needed or when thrombolytics are contraindicated. We describe our clinical and technical experience with the FlowTriever mechanical thrombectomy device in patients with acute PE.
A retrospective analysis was performed on all cases of acute PE treated with the FlowTriever device at a single tertiary care hospital system during the trial period (November 2019-January 2020). Technical and clinical results, including complications, are reported.
Technical success was achieved in all eight successive cases (seven cases of submassive and 1 case of massive PE). Mean pulmonary artery pressure (MPAP) improved significantly after mechanical thrombectomy (27.8 ± 6.4 mmHg preprocedure; 20.5 ± 3.8 mmHg postprocedure; 7.3 ± 5.2 mmHg decrease after the procedure; P = 0.016). Hemoglobin levels did not change significantly after mechanical thrombectomy (11.8 g/dl ± 3.4 preprocedure; 9.9 g/dl ± 2.1 postprocedure; P = 0.20). Reduction in MPAP was achieved in 88% of cases (7/8) and hypoxia improved in all the nonintubated patients (7/7). Mortality observed in one patient with a massive central PE, was not related to the procedure. No mortality or procedural complications were observed in patients with submassive PE.
The positive initial clinical experience and safety profile using the FlowTriever in the treatment of acute PE suggests, it has the potential to fill the unmet needs of a good mechanical thrombectomy device to treat massive and submassive high-risk PE especially when thrombolytics are contraindicated.
在急性肺栓塞（PE）的治疗中，机械血栓切除术发挥着重要作用，无论是在需要快速溶解血栓还是溶栓药物禁忌的情况下。我们描述了在急性PE患者中使用FlowTriever机械血栓切除装置的临床和技术经验。
对试验期间（2019年11月至2020年1月）在单一三级医疗医院系统中接受FlowTriever装置治疗的所有急性PE病例进行回顾性分析。报告了技术和临床结果，包括并发症。
连续8例（7例次大面积和1例次大块PE）均取得技术成功。机械血栓切除术后平均肺动脉压（MPAP）显著改善（术前27.8±6.4 mmHg；术后20.5±3.8 mmHg；术后降低7.3±5.2 mmHg；P = 0.016）。机械血栓切除术后血红蛋白水平无显著变化（术前11.8 g/dl±3.4；术后9.9 g/dl±2.1；P = 0.20）。88%的病例（7/8）实现了MPAP降低，所有未插管患者（7/7）的低氧血症得到改善。1例大块中央型PE患者的死亡与手术无关。次大面积PE患者未观察到死亡或手术并发症。
使用FlowTriever治疗急性PE的初步积极临床经验和安全性表明，它有可能满足治疗大块和次大块高危PE的良好机械血栓切除装置的未满足需求，特别是在溶栓药物禁忌时。
