Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492013000100010
Jornal Vascular Brasileiro
Case report

Endovascular management of massive pulmonary embolism with clot fragmentation and suction

Sergio Quilici Belczak; Igor Rafael Sincos; Ricardo Aun; Alex Lederman; Boulanger Mioto Neto; Fernando Saliture; Manoel Lobato

Downloads: 0
Views: 1292

Abstract

Massive pulmonary embolism with right ventricular dysfunction may be treated with thrombolysis, embolectomy, or percutaneous mechanical thrombectomy. This study describes our experience with two patients that had massive pulmonary embolism and were treated with percutaneous mechanical thrombectomy and reports on the mid-term results of this procedure. A 28-year-old man and a 70-year-old woman were diagnosed with deep venous thrombosis and massive pulmonary embolism. They first had lower limb edema followed by sudden onset of dyspnea. Their physical examination revealed edema, tachypnea, chest discomfort and jugular turgescence. Both needed to receive oxygen using a nasal cannula. Doppler ultrasound, echocardiography, and computed tomography angiography were used to establish the diagnoses. Patients underwent percutaneous mechanical thrombectomy using the Aspirex® system (Straub Medical), and their clinical condition and imaging study findings improved substantially. At mid-term follow-up, patient conditions were improving satisfactorily.

Keywords

pulmonary embolism, endovascular procedures, thrombectomy

References

Kucher N, Goldhaber SZ. Mechanical catheter intervention in massive pulmonary embolism: proof of concept. Chest. 2008;134(1):2-4.

Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Massive pulmonary embolism. Circulation. 2006;113(4):577-82.

Pulido T, Aranda A, Zevallos MA. Pulmonary embolism as a cause of death in patients with heart disease: an autopsy study. Chest. 2006;129(5):1282-7.

Wood KE. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 2002;121(3):877-905.

Eid-Lidt G, Gaspar J, Sandoval J. Combined clot fragmentation and aspiration in patients with acute pulmonary embolism. Chest. 2008;134(1):54-60.

Góes Junior AMO, Mascarenhas F, Mourão GS, Elkis H, Pieruccetti MA. Tratamento de tromboembolismo pulmonar por aspiração percutânea do trombo: relato de caso. J Vasc. Bras. 2010;9(3):190-5.

Skaf E, Beemath A, Siddiqui T, Janjua M, Patel NR, Stein PD. Catheter-tip embolectomy in the management of acute massive pulmonary embolism. Am J Cardiol. 2007;99(1):415-20.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddfb3090e88254d4b61c40d jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections