Garza Jay E, Shah Priti, Patel Napoleon, Wang Daniel
Dermatology, McGovern Medical School, Houston, USA.
Internal Medicine, McGovern Medical School, Houston, USA.
Cureus. 2024 Jul 7;16(7):e64031. doi: 10.7759/cureus.64031. eCollection 2024 Jul.
Pulmonary embolism (PE) is a devastating disease that can range in severity from asymptomatic to fatal. The severity and the intervention required depend on the degree of hemodynamic instability and evidence of right heart strain demonstrated on diagnostic testing. Interventions include solely anticoagulation, systemic thrombolysis, catheter-directed therapies, or surgical embolectomy depending on the severity, patient's clinical picture, and clinician choice. Currently, there is a lack of evidence regarding which treatment is most suitable for submassive PE. This report demonstrates the benefits of aspiration thrombectomy, a catheter-directed therapy, utilizing the 24Fr Triever Aspiration Catheter (FlowTriever system;Inari Medical, Irvine, California, United States) in a 57-year-old male patient with submassive PE. The FlowTriever retrieval/aspiration system is a single-use mechanical thrombectomy device indicated for use in the peripheral vasculature and pulmonary arteries. The patient presented with syncope and concern for head trauma ultimately requiring suction embolectomy utilizing the Inari FlowTriever system. We conclude that submassive PE can be effectively treated with aspiration thrombectomy in addition to long-term anticoagulation with excellent clinical outcomes.
肺栓塞(PE)是一种严重的疾病,严重程度从无症状到致命不等。其严重程度及所需的干预措施取决于血流动力学不稳定的程度以及诊断检查中显示的右心劳损证据。干预措施包括单纯抗凝、全身溶栓、导管定向治疗或手术取栓,具体取决于严重程度、患者的临床表现以及临床医生的选择。目前,关于哪种治疗最适合亚大块肺栓塞缺乏证据。本报告展示了使用24Fr Triever抽吸导管(FlowTriever系统;Inari Medical,美国加利福尼亚州欧文市)对一名57岁亚大块肺栓塞男性患者进行抽吸血栓切除术(一种导管定向治疗)的益处。FlowTriever取栓/抽吸系统是一种一次性使用的机械血栓切除术设备,适用于外周血管系统和肺动脉。该患者出现晕厥,因担心头部外伤最终使用Inari FlowTriever系统进行了抽吸取栓术。我们得出结论,除了长期抗凝外,亚大块肺栓塞可通过抽吸血栓切除术有效治疗,临床效果良好。