Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, USA.
Division of Cardiology, Grady Memorial Hospital, Atlanta, Georgia, USA.
Catheter Cardiovasc Interv. 2021 Apr 1;97(5):869-873. doi: 10.1002/ccd.29391. Epub 2020 Nov 23.
In the previous literature, the prevalence of right atrial (RA) clot-in-transit associated with pulmonary embolism is around 4-18% with an associated mortality of 80-100% in untreated cases. Surgical thrombo-embolectomy has been the mainstay of treatment for stable patients but the data for percutaneous thrombo-embolectomy is lacking in the literature. We present a series of three cases of right atrium clot-in-transit treated with catheter-based therapies with Inari FlowTriever® (Inari Medical, Irvine, CA). Our three patients had different clinical profiles and presentations of right atrial clot-in-transit. All of the subjects had contraindications to surgical thrombo-embolectomy and thrombolytic therapy. Catheter based embolectomy using Inari FlowTriever® was successfully performed in all the patients. As the data on this intervention is sparse, our case series highlights successful catheter based thrombo-embolectomies in high-risk individuals with right atrial clot in-transit with or without pulmonary embolism.
在之前的文献中,与肺栓塞相关的右心房(RA)栓子在移行中的发生率约为 4-18%,未经治疗的情况下死亡率为 80-100%。对于稳定型患者,外科血栓切除术一直是主要的治疗方法,但文献中缺乏经皮血栓切除术的数据。我们报告了三例使用 Inari FlowTriever®(Inari Medical,加利福尼亚州欧文)进行基于导管的治疗的右心房栓子在移行中的病例系列。我们的三个患者具有不同的临床特征和右心房栓子在移行中的表现。所有患者均有外科血栓切除术和溶栓治疗的禁忌证。所有患者均成功地进行了基于导管的 Inari FlowTriever®取栓术。由于该干预措施的数据较少,我们的病例系列强调了在有或没有肺栓塞的情况下,对有高风险的右心房栓子在移行中的个体成功进行基于导管的血栓切除术。