Applications of percutaneous mechanical thrombectomy in pulmonary embolism.

Percutaneous mechanical thrombectomy (PMT) has matured into a reliable and valuable therapeutic tool in acute vascular diseases. PMT devices are designed to achieve rapid clearance of acute occlusion in large arteries and veins. This article provides a summary of cumulated experience on pulmonary embolism (PE) treatment with PMT devices. PMT devices are a heterogeneous group of devices that uses different forms of energy. Most of the devices do not totally eliminate thrombus rather fragment in small particles. The rationale of PMT is based on the rapid relief of central pulmonary obstruction. PMT in massive PE provides efficacious and safe debulking of centrally located thrombus in PE, lowering pulmonary artery pressures and improving hemodynamics and blood oxygenation. This results in lowering mortality if compared with natural history of PE, and reduced procedure time if compared with pharmacological thrombolysis. The clinical indications for percutaneous intervention in PE are discussed in the text. Copyright 2003 Elsevier Inc. All rights reserved.