login
  Password reminder
Vascular News
Contact the editor Visit Vascular News Twitter feed Visit Vascular News Facebook page
 

Long-term outcomes of percutaneous mechanical thrombectomy for severe pulmonary embolism


Monday, 05 Mar 2012 16:58
Guering Eid-Lidt
Guering Eid-Lidt


Guering Eid-Lidt, Department of Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico, spoke about long-term outcomes of percutaneous mechanical thrombectomy for severe pulmonary embolism at the iCON meeting in Arizona, USA.


Eid-Lidt said that percutaneous mechanical thrombectomy is currently the only therapeutic alternative to thrombolysis and surgical embolectomy in patients with severe pulmonary embolism and right ventricular dysfunction with major contraindications to thrombolytic therapy, increased bleeding risk, failed thrombolysis, or unavailable surgical thrombectomy.


“The mortality rate in patients with severe acute pulmonary embolism, systolic blood pressure <90mmHg and severe acute right ventricular failure is approximately 50%. However, one third of the patients with massive pulmonary embolism are not eligible for thrombolysis, because of major contraidications, such as prior surgery, trauma, stroke, or advanced cancer,” he noted.

 

“Catheter thrombectomy and surgical embolectomy are alternative treatment modalities to thrombolysis, particularly in the presence of an increased bleeding risk or failed thrombolysis.”

 

“Pooled data of a sistematic review and a meta-analysis of catheter-directed therapy showed a global clinical success of 86.5%. When used in combination with a thrombolytic agent, the success rate with catheter-directed therapy increased up to 91.2%. A major complication rate of 10.3% has been reported,” Eid-Lidt said.

 

The Instituto Nacional de Cardiología Ignacio Chávez’s preliminary experience of clot fragmentation and aspiration in 18 patients with massive pulmonary embolism, right ventricular dysfunction, and major contraindications to thrombolytic therapy (increased bleeding risk, failed thrombolysis, or unavailable surgical thrombectomy) was published in CHEST in 2008. In the study, the device used was the Aspirex thrombectomy system from Straub Medical. The in-hospital major complications rate was 11.1%; one patient died from refractary shock, and one patient had intracerebral haemorrhage with minor neurologic sequelae.

 

To date, Eid-Lidt said, 46 patients have undergone mechanical thrombectomy in the institution. Follow-up over six months has been completed in 35 patients. Ninety per cent of the patients presented a New York Heart Association functional class 1 during clinical follow-up (37.3±22.7months). All patients have had implanted an antiembolic filter in the inferior vena cava, and they were receiving oral anticoagulants.




Add New Comment

Most popular


DEFINITIVE LE study results show directional atherectomy is safe and effective in claudication and critical limb ischaemia patients
Friday, 29 Aug 2014
The multicentre, 800-patient study also demonstrated that directional atherectomy was non-inferior for treating peripheral arterial disease in patients with diabetes compared with those without ... DEFINITIVE LE study results show directional atherectomy is safe and effective in claudication and critical limb ischaemia patients

Incraft low-profile endograft launched in Europe and Canada
Wednesday, 10 Sep 2014
Cordis announced on 10 September the launch of its Incraft AAA Stent Graft System, an ultra-low profile device for use during endovascular aneurysm repair (EVAR) for patients suffering from ... Incraft low-profile endograft launched in Europe and Canada

First patient enrolled in US study of Novate’s Sentry IVC filter
Monday, 22 Sep 2014
Novate Medical has announced that Souheil Saddekni, professor of Vascular and Interventional Radiology at the University of Alabama, Birmingham, USA, has enrolled the first patient in the SENTRY IDE ... First patient enrolled in US study of Novate’s Sentry IVC filter

Features


Not all drug-eluting balloons are equal
Wednesday, 15 Oct 2014
Thomas Zeller, Bad Krozingen, Germany, analyses the results of two recent randomised controlled trials comparing drug-eluting balloons to angioplasty alone in femoropopliteal lesions. Not all drug-eluting balloons are equal

Renal stenting may benefit patients excluded from randomised trials, says expert consensus
Wednesday, 15 Oct 2014
Sahil A Parikh, Case Western Reserve University School of Medicine, Cleveland, USA, speaks to Vascular News about the Society for Cardiovascular Angiography and Interventions expert consensus on ... Renal stenting may benefit patients excluded from randomised trials, says expert consensus

Profiles


Martin Björck
Wednesday, 01 Oct 2014
Martin Björck, Uppsala University Hospital, Sweden, holds the only professor-chair of vascular ... Martin Björck

Cliff Shearman
Thursday, 03 Jul 2014
A former president of the Vascular Society of Great Britain and Ireland, Cliff Shearman was ... Cliff Shearman

Cardiac Rhythm News Vascular News Cardiovascular News Interventional News Spinal News NeuroNews
BIBA Medical BIBA MedTech Insights CX Symposium ilegx
 
Password Reminder

BIBA Medical, 526 Fulham Road, Fulham, London, SW6 5NR.
TEL: +44 (0)20 7736 8788 FAX: +44 (0)20 7736 8283 EMAIL: 
info@bibamedical.com
© BIBA Medical Ltd is a company registered in England and Wales with company number 2944429.
VAT registration number 730 6811 50.
Site Map | Terms and Conditions