MASSIVE PULMONARY-EMBOLISM - PRELIMINARY-RESULTS OF TREATMENT WITH THE AMPLATZ THROMBECTOMY DEVICE

PURPOSE: To determine the feasibility of using the Amplatz thrombectom y device (ATD) to treat massive pulmonary embolism (PE). PATIENTS AND METHODS: Five patients (four men, one woman; mean age, 45.2 years) wit h massive PE underwent mechanical thrombectomy with the ATD, which cre ates a vortex that pulverizes and recirculates the clots within the pu lmonary circulation. The patients were followed up for 7-18 months aft er thrombectomy. RESULTS: Marked improvement in pulmonary perfusion wa s observed in one patient and moderate improvement was observed in thr ee patients at angiography and ventilation-perfusion scanning. No chan ges could be assessed in one patient who died shortly after the proced ure. One patient developed hemoptysis during the procedure, most likel y because of a reperfusion syndrome. A reduction in pulmonary artery p ressure was observed in only one patient; the remaining patients had i ncreased pressure. The four surviving patients were discharged within 8 days. CONCLUSION: Mechanical thrombectomy with the ATD provides rapi d debulking of thrombus in some patients with massive PE and has the p otential to improve treatment and outcomes of the most sick patients.