Large-bore Aspiration Thrombectomy with the FlowTriever System for the Treatment of Pulmonary Embolism: A Large Single-Center Retrospective Analysis.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS CardioVascular and Interventional Radiology Pub Date : 2024-09-01 Epub Date: 2024-08-07 DOI:10.1007/s00270-024-03819-5

Travis Pebror, Adam William Schmitz, Andrew Gauger, Reid Masterson, Sabah David Butty

{"title":"Large-bore Aspiration Thrombectomy with the FlowTriever System for the Treatment of Pulmonary Embolism: A Large Single-Center Retrospective Analysis.","authors":"Travis Pebror, Adam William Schmitz, Andrew Gauger, Reid Masterson, Sabah David Butty","doi":"10.1007/s00270-024-03819-5","DOIUrl":null,"url":null,"abstract":"Purpose: Evaluate the outcomes of patients undergoing large-bore aspiration thrombectomy for the treatment of pulmonary embolism at a large university medical center.Materials and methods: All patients treated for pulmonary embolism with the FlowTriever System (Inari Medical, Irvine, CA) between September 2019 and January 2023 were retrospectively analyzed. The primary safety and effectiveness outcomes included 7- and 30-day all-cause mortality, major bleeding, procedure-associated clinical decompensation, pulmonary vascular or cardiac injury, and pulmonary artery pressure reduction. Additional outcomes included technical success (completing thrombectomy with the device as intended), changes in hemodynamics and supplemental oxygen requirements, and postprocedural intensive care unit stay.Results: A total of 286 patients were identified. The mean age was 60.5 years, and 90.9% of patients presented with intermediate-risk pulmonary embolism. Technical success was achieved in 96.9% (n = 277) of cases. The average reduction in mean pulmonary arterial pressure was 6.8 mmHg, from 28.7 ± 9.0 to 21.9 ± 8.0 mmHg (p < 0.0001). Two major bleeds (0.7%), 2 pulmonary vascular injuries (0.7%), and 4 (1.4%) procedure-associated decompensations were reported, but no device-related deaths occurred. The mean post-procedure intensive care unit stay was 2.0 ± 4.1 days, and 49.3% of patients had no postprocedural intensive care unit admittance. The overall 7-day and 30-day all-cause mortality rates were 2.4% and 6.7%, respectively, with a 30-day pulmonary embolism-related mortality rate of 3.5%.Conclusion: This non-industry-sponsored single-center analysis of large-bore aspiration thrombectomy in a large population corroborates the findings of other studies and confirms that this approach is safe and effective for the treatment high- and intermediate-risk pulmonary embolism.Level of evidence iv: Retrospective observational study.","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379772/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CardioVascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00270-024-03819-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Evaluate the outcomes of patients undergoing large-bore aspiration thrombectomy for the treatment of pulmonary embolism at a large university medical center.

Materials and methods: All patients treated for pulmonary embolism with the FlowTriever System (Inari Medical, Irvine, CA) between September 2019 and January 2023 were retrospectively analyzed. The primary safety and effectiveness outcomes included 7- and 30-day all-cause mortality, major bleeding, procedure-associated clinical decompensation, pulmonary vascular or cardiac injury, and pulmonary artery pressure reduction. Additional outcomes included technical success (completing thrombectomy with the device as intended), changes in hemodynamics and supplemental oxygen requirements, and postprocedural intensive care unit stay.

Results: A total of 286 patients were identified. The mean age was 60.5 years, and 90.9% of patients presented with intermediate-risk pulmonary embolism. Technical success was achieved in 96.9% (n = 277) of cases. The average reduction in mean pulmonary arterial pressure was 6.8 mmHg, from 28.7 ± 9.0 to 21.9 ± 8.0 mmHg (p < 0.0001). Two major bleeds (0.7%), 2 pulmonary vascular injuries (0.7%), and 4 (1.4%) procedure-associated decompensations were reported, but no device-related deaths occurred. The mean post-procedure intensive care unit stay was 2.0 ± 4.1 days, and 49.3% of patients had no postprocedural intensive care unit admittance. The overall 7-day and 30-day all-cause mortality rates were 2.4% and 6.7%, respectively, with a 30-day pulmonary embolism-related mortality rate of 3.5%.

Conclusion: This non-industry-sponsored single-center analysis of large-bore aspiration thrombectomy in a large population corroborates the findings of other studies and confirms that this approach is safe and effective for the treatment high- and intermediate-risk pulmonary embolism.

Level of evidence iv: Retrospective observational study.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

使用 FlowTriever 系统进行大口径吸栓术治疗肺栓塞：大型单中心回顾性分析。

目的：评估一家大型大学医疗中心接受大口径抽吸血栓切除术治疗肺栓塞患者的疗效：回顾性分析了 2019 年 9 月至 2023 年 1 月期间使用 FlowTriever 系统（Inari Medical，Irvine，CA）治疗肺栓塞的所有患者。主要安全性和有效性结果包括 7 天和 30 天全因死亡率、大出血、与手术相关的临床失代偿、肺血管或心脏损伤以及肺动脉压力降低。其他结果包括技术成功率（按照预期使用设备完成血栓切除术）、血流动力学和补氧需求的变化以及术后重症监护室的住院时间：结果：共确定了 286 名患者。平均年龄为 60.5 岁，90.9% 的患者为中危肺栓塞。96.9%的病例（n = 277）取得了技术成功。平均肺动脉压平均降低了 6.8 mmHg，从 28.7 ± 9.0 mmHg 降至 21.9 ± 8.0 mmHg（p 结论：这是一项非工业赞助的单项研究：这项由非行业赞助的单中心大口径抽吸血栓切除术分析证实了其他研究的结果，并证实这种方法对于治疗高危和中危肺栓塞是安全有效的：回顾性观察研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

CardioVascular and Interventional Radiology 医学-核医学

CiteScore

5.50

自引率

13.80%

发文量

306

审稿时长

3-8 weeks

期刊介绍： CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.