BACKGROUND AND AIM: Angiojet Rheolytic thrombectomy (ART) has been utilized as a catheter-based treatment in acute pulmonary embolism (PE). In this study based on our seven-year experience on ART in patients with PE, we evaluated efficacy and safety outcomes of ART. METHODS: Our study is based on retrospective evaluation of 56 patients with high- and intermediate-high-risk PE, age (62 years; interquartile-range (IQR): 50-73) who underwent ART. RESULTS: High- and intermediate-high-risk were noted in 21.4 % and in 78.6 % of patients, respectively. ART duration was 304(IQR: 246-468) seconds. Measures of obstruction, right to left ventricle diameter ratio (RV/LV ratio), right to left atrial diameter ratio and pulmonary arterial pressures were improved (p<0.001 for all). During hospital stay, acute renal failure, major and minor bleeding, and mortality rates were 37.5%, 7.1%, 12.5%, and 8.9%, respectively. Aging related to post-procedural nephropathy while high-risk status was associated with in-hospital mortality (p=0.006) and long-term mortality. CONCLUSIONS: The ART resulted in significant and clinically relevant improvements in the pulmonary arterial thrombotic burden, RV strain and hemodynamics in patients with PE at high- and intermediate-high-risk. Aging increased the risk of post-procedural nephropathy whereas baseline high-risk status predicted in-hospital and long-term mortality.
BACKGROUND AND AIM: Angiojet Rheolytic thrombectomy (ART) has been utilized as a catheter-based treatment in acute pulmonary embolism (PE). In this study based on our seven-year experience on ART in patients with PE, we evaluated efficacy and safety outcomes of ART. METHODS: Our study is based on retrospective evaluation of 56 patients with high- and intermediate-high-risk PE, age (62 years; interquartile-range (IQR): 50-73) who underwent ART. RESULTS: High- and intermediate-high-risk were noted in 21.4 % and in 78.6 % of patients, respectively. ART duration was 304(IQR: 246-468) seconds. Measures of obstruction, right to left ventricle diameter ratio (RV/LV ratio), right to left atrial diameter ratio and pulmonary arterial pressures were improved (p<0.001 for all). During hospital stay, acute renal failure, major and minor bleeding, and mortality rates were 37.5%, 7.1%, 12.5%, and 8.9%, respectively. Aging related to post-procedural nephropathy while high-risk status was associated with in-hospital mortality (p=0.006) and long-term mortality. CONCLUSIONS: The ART resulted in significant and clinically relevant improvements in the pulmonary arterial thrombotic burden, RV strain and hemodynamics in patients with PE at high- and intermediate-high-risk. Aging increased the risk of post-procedural nephropathy whereas baseline high-risk status predicted in-hospital and long-term mortality.
Authors: Stavros V Konstantinides; Adam Torbicki; Giancarlo Agnelli; Nicolas Danchin; David Fitzmaurice; Nazzareno Galiè; J Simon R Gibbs; Menno V Huisman; Marc Humbert; Nils Kucher; Irene Lang; Mareike Lankeit; John Lekakis; Christoph Maack; Eckhard Mayer; Nicolas Meneveau; Arnaud Perrier; Piotr Pruszczyk; Lars H Rasmussen; Thomas H Schindler; Pavel Svitil; Anton Vonk Noordegraaf; Jose Luis Zamorano; Maurizio Zompatori Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983
Authors: Navkaranbir S Bajaj; Rajat Kalra; Pankaj Arora; Sameer Ather; Jason L Guichard; W Jake Lancaster; Nirav Patel; Fabio Raman; Garima Arora; Firas Al Solaiman; D Trey Clark; Louis J Dell'Italia; Massoud A Leesar; James E Davies; David C McGiffin; Mustafa I Ahmed Journal: Int J Cardiol Date: 2016-09-20 Impact factor: 4.164
Authors: Fulvio Stacul; Aart J van der Molen; Peter Reimer; Judith A W Webb; Henrik S Thomsen; Sameh K Morcos; Torsten Almén; Peter Aspelin; Marie-France Bellin; Olivier Clement; Gertraud Heinz-Peer Journal: Eur Radiol Date: 2011-08-25 Impact factor: 5.315
Authors: William T Kuo; Michael K Gould; John D Louie; Jarrett K Rosenberg; Daniel Y Sze; Lawrence V Hofmann Journal: J Vasc Interv Radiol Date: 2009-11 Impact factor: 3.464