Acute pulmonary embolism treatment in lung transplant recipients: mechanical thrombectomy and catheter directed thrombolysis.

Abstract

Purpose: Acute pulmonary embolism (PE) presents a significant challenge in lung transplant recipients (LTR), even with prophylactic anticoagulation. Due to the heightened risk of complications in this population, the optimal treatment approach for acute PE remains uncertain. This retrospective case series aims to elucidate the outcomes of percutaneous mechanical thrombectomy with the Inari device (MT) and catheter-directed thrombolysis (CDT) in managing acute PE in lung transplant patients.

Materials and methods: This study examines the treatment outcomes of nine consecutive post-lung transplantation patients with acute PE confirmed with Computed Tomography Angiography (CTA). Treatment interventions included either MT or CDT. Follow-up assessments encompassed a minimum of one year and up to 3 years post-treatment, evaluating various parameters including ICU stay, ventricular pressures, pulmonary function, and laboratory tests.

Results: Both MT and CDT achieved a 100% technical success rate, leading to the successful restoration of pulmonary blood flow and improvements in hemodynamic parameters, with a one-year survival rate of 100%.

Conclusion: Percutaneous treatments, including MT and CDT, demonstrate feasibility and efficacy in managing acute PE among lung transplant patients. These treatments lead to rapid thrombus resolution, post-treatment improvements, and enhanced overall survival.