Latsios George, Mantzouranis Emmanouil, Kachrimanidis Ioannis, Dimitroglou Yannis, Stroumpouli Evangelia, Aggeli Constantina, Tsioufis Konstantinos
1st Department of Cardiology & Catheterization Laboratory, General Hospital of Athens "Hippokration", Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Catheter Cardiovasc Interv. 2025 Aug;106(2):1041-1050. doi: 10.1002/ccd.31630. Epub 2025 Jun 2.
Acute pulmonary embolism (PE) remains the third cardiovascular cause of death, with significant mortality rates even in the intermediate risk spectrum.
The aim of this prospective cohort study was to investigate outcomes of patients with intermediate-high risk PE, treated with percutaneous mechanical thrombectomy (PMT) using the FLowtriever sytem.
Twenty-five consecutive patients (mean age 62 ± 16 years) treated with PMT for intermediate-high risk PE over an 18-month period were included. These patients were referred to this treatment by our local PERT, on a semi-urgent basis, based on recent promising large population registry data. Clinical, echocardiographic, and invasive data before and after the procedure as well as procedure-related adverse events were documented.
After PMT, an immediate reduction was noticed in systolic pulmonary arterial pressure (sPAP) from 64 ± 10 to 38 ± 9 mmHg (p = 0.006) and heart rate from 111 ± 5 to 89 ± 8 bpm (p = 0.001). The cardiac index was statistically significantly increased from a baseline 2.1 L/min/m (1.3-2.4) to a post-op value of 2.6 (2.2-3.7) L/min/m and finally 3.1 (2.6-4) L/min/m at 48 h (p = 0.007). Regarding right ventricular function, the 48 h echocardiographic assessment showed a significant reduction of the RV/LV ratio by 17.5% (p < 0.001). No serious complications or deaths occurred during hospitalization and at 6-month follow-up.
In our initial experience of treating intermediate-high-risk PE patients with the specially designed large-bore PMT system, we document a statistically significant improvement in all PE-related severity indices, in accordance with large cohort published data. Moreover, our procedure-related complication rate was very low.
急性肺栓塞（PE）仍然是心血管疾病的第三大死因，即使在中危风险范围内，死亡率也很高。
这项前瞻性队列研究的目的是调查使用Flowtriever系统进行经皮机械血栓切除术（PMT）治疗的中高危PE患者的预后。
纳入了在18个月期间连续接受PMT治疗中高危PE的25例患者（平均年龄62±16岁）。根据近期有前景的大样本登记数据，这些患者由我们当地的肺栓塞反应团队（PERT）半紧急转诊接受此治疗。记录手术前后的临床、超声心动图和有创数据以及与手术相关的不良事件。
PMT术后，收缩期肺动脉压（sPAP）立即从64±10 mmHg降至38±9 mmHg（p = 0.006），心率从111±5次/分钟降至89±8次/分钟（p = 0.001）。心脏指数从基线的2.1 L/min/m²（1.3 - 2.4）显著增加至术后的值2.6（2.2 - 3.7）L/min/m²，最终在48小时时达到3.1（2.6 - 4）L/min/m²（p = 0.007）。关于右心室功能，48小时的超声心动图评估显示右心室与左心室比值显著降低17.5%（p < 0.001）。住院期间及6个月随访时未发生严重并发症或死亡。
在我们使用专门设计的大口径PMT系统治疗中高危PE患者的初步经验中，我们记录到所有与PE相关的严重程度指标均有统计学显著改善，与已发表的大样本队列数据一致。此外，我们的手术相关并发症发生率非常低。
