Mechanical Thrombectomy for High-Risk Pulomonary Embolism: A Retrospective Single Center Experience

Monday, March 31, 2025

3:54 PM – 4:03 PM CT

Location: Music City Center, 201 AB

Presenting Author(s)

AP

Andrew Pham, MD

Resident Physician
Corewell Health William Beaumont Universiity Hospital, United States

Author/Co-author(s)

VS

Vincent Shallal, MD, MPH

Resident
William Beaumont Univeristy Hospital, United States
VH

Verna Halim, BS

Medical Student
Oakland University William Beaumont School of Medicine, United States
JC

Joseph Ciacci, DO

Integrated Interventional Radiology Program Director
Corewell Health, United States
TB

Terry Bowers, MD

Attending Physician
Corewell Health William Beaumont Univeristy Hospital, United States

Purpose: In hospital all-cause mortality for high-risk pulmonary embolism is approximately 30%. This retrospective single center analysis investigates the safety and effectiveness of mechanical thrombectomy in patients with high-risk pulmonary embolism.

Materials and Methods: A single center retrospective analysis of pulmonary embolus mechanical thrombectomy with the FlowTriever System (Inari Medical). Outcomes over a 30-day period were analyzed for patients with high-risk PE based on hypotension requiring vasopressor support, RV/LV ratio ≥ 2.0, peak systolic pulmonary arterial pressure ≥ 65 mmHg, or mean pulmonary artery pressure ≥ 40 mmHg. Adverse events were classified based upon the Society of Interventional Radiology Specialty- Specific System.

Results: Of the 442 patients who underwent mechanical thrombectomy, 156 (35.2%) were deemed high risk PE. 15 (9.6%) patients had hypotension requiring vasopressor support, 77 (49.3%) had an RV/LV≥ 2.0, 66 (42.3%) had peak systolic pulmonary arterial pressure ≥ 65 mmHg and 51 (32.6%) had a mean pulmonary artery pressure ≥ 40 mmHg. The post mechanical thrombectomy peak systolic pulmonary arterial pressure decreased by an average of 14.5 mmHg and the mean pulmonary artery pressure decreased by an average of 8.5 mmHg. The average ICU stay was 5.0 days. The 48-hour all-cause mortality was 3.8%, and 30-day all-cause mortality was 8.9%. 10 (6.4%) major adverse events occurred within 48 hours.

Conclusion: Mechanical thrombectomy demonstrated safety and efficacy in patients with high-risk pulmonary embolism.