AIMS: To provide a systematic review of catheter-based therapies of acute pulmonary embolism. METHODS AND RESULTS: Studies published in peer-reviewed journals before February 2017 were included and categorized according to the mechanism of thrombus removal: fragmentation, rheolytic therapy, aspiration or catheter-directed thrombolysis. Strengths, challenges and the level of evidence of each device were evaluated. We found 16 different catheter-based therapies for acute PE; all but one being used off-label. The majority of procedures involve catheter-directed thrombolysis. Aspiration therapy shows promise, but limited data are available. Rheolytic therapy should be used with caution, if at all, due to the high number of associated complications. CONCLUSIONS: Catheter-based therapies show promise as a treatment for acute PE, though evidence is lacking. Further research into the efficacy and safety of devices is needed.
AIMS: To provide a systematic review of catheter-based therapies of acute pulmonary embolism. METHODS AND RESULTS: Studies published in peer-reviewed journals before February 2017 were included and categorized according to the mechanism of thrombus removal: fragmentation, rheolytic therapy, aspiration or catheter-directed thrombolysis. Strengths, challenges and the level of evidence of each device were evaluated. We found 16 different catheter-based therapies for acute PE; all but one being used off-label. The majority of procedures involve catheter-directed thrombolysis. Aspiration therapy shows promise, but limited data are available. Rheolytic therapy should be used with caution, if at all, due to the high number of associated complications. CONCLUSIONS: Catheter-based therapies show promise as a treatment for acute PE, though evidence is lacking. Further research into the efficacy and safety of devices is needed.
Authors: Aleksander Araszkiewicz; Marcin Kurzyna; Grzegorz Kopeć; Marek Roik; Szymon Darocha; Arkadiusz Pietrasik; Mateusz Puślecki; Andrzej Biederman; Roman Przybylski; Jakub Stępniewski; Michał Furdal; Tatiana Mularek-Kubzdela; Piotr Pruszczyk; Adam Torbicki Journal: Cardiol J Date: 2019 Impact factor: 2.737