Massive Pulmonary Embolism: Treatment with the Hydrolyser Thrombectomy Catheter
Section snippets
PATIENTS AND METHODS
We treated 11 patients (eight women, three men) with mean age of 61 years (range, 37–79 y) in a prospective protocol. All were inpatients who entered the hospital for surgery, trauma, or other causes without symptoms of PE or DVT and developed thromboembolic disease during their hospital stay. These patients had acute onset (<5 days) of symptoms of PE with hemodynamic compromise, pulmonary hypertension, and right ventricle overload. Five patients had contraindications to thrombolytic drugs
RESULTS
Ten patients (90.9%) recovered from massive PE and were discharged within 11 days. A representative case is shown in Figure 2.
With this technique, we removed a mean of 74.06% of thrombus (± 13.46%), calculated by semiquantitative computed analysis (Fig 3 shows analysis of the case in Fig 2). The angiographic severity indexes before and after thrombectomy were 14.7 ± 2.6 and 7.5 ± 2.7, respectively (P < .001) (Fig 4).
Pulmonary artery pressure decreased from a mean of 45.5 mm Hg ± 14.2 to 29.5 mm
DISCUSSION
The present study evaluated the therapeutic results of PMT in acute massive PE with use of a hydrodynamic thrombectomy catheter in a small number of selected patients. We included only patients with thromboembolic disease that had developed during their hospital stay to assure a short evolution time, because the Hydrolyser works better on fresh, nonorganized thrombus (5). Approximately 74% of thrombus was removed with use of the Hydrolyser. Ninety-one percent of patients (10 of 11) recovered
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From the 1999 SCVIR Annual Meeting.