Mechanical Thrombectomy for High-Risk Pulmonary Embolism: A Retrospective Single-Center Experience

Authors

Vincent Shallal, Corewell Health East Resident
Andrew Pham, Corewell Health East Resident
Verna Halim, Oakland University William Beaumont School of Medicine Medical Student
Joseph Ciacci, Corewell Health East
Terry Bowers, Corewell Health East

Document Type

Conference Proceeding

Publication Date

3-2025

Publication Title

Journal of Vascular and Interventional Radiology

Abstract

Purpose: In-hospital all-cause mortality for high-risk pulmonary embolism is approximately 30%. This retrospective -single-center analysis investigates the safety and effectiveness of mechanical thrombectomy in patients with high-risk pulmonary embolism. Materials and Methods: A -single-center retrospective analysis of pulmonary embolus mechanical thrombectomy with the FlowTriever System (Inari Medical). Outcomes over a 30-day period were analyzed for patients with high-risk PE based on hypotension requiring vasopressorsupport, RV/LV ratio ≥2.0, peak systolic pulmonary arterial pressure ≥65 mmHg, or mean pulmonary artery pressure ≥40 mmHg. Adverse events were classified based on the Society of Interventional Radiology Specialty-Specific System. Results: Of the 442 patients who underwent mechanical thrombectomy, 156 (35.2%) were deemed -high-risk PE. 15 (9.6%) patients had hypotension requiring vasopressorsupport, 77 (49.3%) had an RV/LV≥2.0, 66 (42.3%) had peak systolic pulmonary arterial pressure ≥65 mmHg and 51 (32.6%) had a mean pulmonary artery pressure ≥40 mmHg. The post-mechanical thrombectomy peak systolic pulmonary arterial pressure decreased by an average of 14.5 mmHg and the mean pulmonary artery pressure decreased by an average of 8.5 mmHg. The average ICU stay was 5.0 days. The 48-hour all-cause mortality was 3.8%, and 30-day all-cause mortality was 8.9%. 10 (6.4%) major adverse events occurred within 48 hours. Conclusion: Mechanical thrombectomy demonstrated safety and efficacy in patients with high-risk pulmonary embolism

Volume

36

Issue

3 Suppl

First Page

S77

Last Page

S77

Recommended Citation

Shallal V, Pham A, Halim V, Ciacci J, Bowers T. Mechanical thrombectomy for high-risk pulmonary embolism: a retrospective single-center experience. J Vasc Interv Radiol. 2025 Mar;36(3 Suppl):S77. doi:10.1016/j.jvir.2024.12.211

Comments

Society of Interventional Radiology (SIR) 50th Annual Scientific Meeting, March 29 - April 2, 2025, Nashville, TN

DOI

10.1016/j.jvir.2024.12.211