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Abstract
Background
The current level of evidence for mechanical thrombectomy (MT) of pulmonary embolism (PE) in patients with patent foramen ovale (PFO) is limited.
Results
This was a retrospective analysis of 9 patients with PFO and acute high-risk or intermediate-high-risk PE, 6 with intermediate-high risk and 3 with high-risk PE. All underwent MT using the Inari FlowTriever System from Dec 2018 to November 2019. Six of these patients had confirmed deep venous thrombosis. The technical and clinical success rate for MT in all patients was 100% and 77.8%, respectively. Right-heart strain improved in 6/8 patients on follow-up echocardiography. Mean main pulmonary artery (MPA) pressure significantly decreased after MT (p < 0.012). One patient presented with altered mental status (somnolence and disorientation) prior to coronary artery angiogram and thrombectomy, developed a middle cerebral artery embolic stroke 1 day after MT, and recovered with minor sequalae and later was discharged. There was no in-hospital mortality.
Conclusions
MT using FlowTriever was feasible and safe, successfully improving MPA pressure in patients presenting with concurrent PFO and PE.
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Details
1 Yale University School of Medicine, Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710); Johns Hopkins University School of Medicine, Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Baltimore, USA (GRID:grid.21107.35) (ISNI:0000 0001 2171 9311)
2 Mount Auburn Hospital, Department of Radiology, Cambridge, USA (GRID:grid.416843.c) (ISNI:0000 0004 0382 382X)
3 Yale University School of Medicine, Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710)