Massive pulmonary embolism: Treatment with the Hydrolyser thrombectomy catheter

PURPOSE: To assess the efficacy of clot removal with use of the Hydrolyser thrombectomy catheter in acute massive pulmonary embolism (PE), MATERIALS AND METHODS: Eleven patients (eight women, three men) with a mean age of 61 (range, 37-79) years with acute massive PE underwent percutaneou s mechanical thrombectomy (PMT) with use of the Hydrolyser, In four patient s with no contraindication, fibrinolysis was performed with use of urokinas e at low doses after thrombectomy, RESULTS: Ten patients (90.9%) recovered from massive PE and were discharged within 11 days. The Urokinase Pulmonary Embolism Trial angiographic severi ty indexes (mean +/- SD) were 14.7 +/- 2.6 and 7.5 +/- 2.7, respectively, b efore and after thrombectomy (P <.001), Partial arterial pressures of O-2 i ncreased from 72.8 mm Hg +/- 16.4 to 93.5 mm Hg +/- 5.6 (P <.005). Pulmonar y artery pressure decreased from 45.5 mm Hg +/- 14.2 to 29.5 mm Hg +/- 13.6 after thrombectomy (P <.0001). Calculated by semiquantitative computed ana lysis, PMT with use of the Hydrolyser removed 74.06% of thrombus +/- 13.46% . One patient developed self-limited hemoptysis immediately after thrombect omy, One patient died during the procedure secondary to PE, CONCLUSION: PMT with use of the Hydrolyser is effective and safe in massive PE, resulting in improved hemodynamics and blood oxygenation and decreased pulmonary artery pressure. It offers an alternative to fibrinolysis and su rgical thrombectomy.