Review of Catheter Thrombectomy Devices

Abstract

Acute massive pulmonary embolism (PE) is a frequently fatal event that causes significant compromise of hemodynamic stability. Unfortunately, mortality rates for PE have remained relatively constant despite advances in prophylactic and treatment measures. In addition to embolus size, symptom recognition for diagnosis and emergent treatment are two distinct factors that dictate survival. Treatment generally includes thrombolytic agents; however, not all patients are candidates for aggressive thrombolytic management. Development of catheter thrombectomy devices provides an alternative treatment modality for severe cases when thrombolytics are contraindicated. Catheter thrombectomy devices have undergone major advances over the last decade, but literature support of their success is limited.

Management of Massive Pulmonary Embolism

“…16 Several mechanical or rheolytic thrombectomy devices not designed for use in large main pulmonary arteries have been investigated in small PE cohort studies (Table 3). [17][18][19][20][21][22][23] The Aspirex device, a highly effective mechanical thrombectomy catheter, has been specifically developed for the treatment of massive PE. 24 The central part of the Aspirex device is a protected, high-speed rotational coil that aspirates, macerates, and removes thrombus through an L-shaped aspiration port at the catheter tip ( Figure 2).…”

Tratamento com sucesso de um caso de tromboembolismo pulmonar maciço com uso de cateter de aspiração a vácuo

“…Devemos lembrar que ainda não há evidências para o uso rotineiro desses cateteres e dispositivos, e que a embolectomia por meio de cateteres é indicada quando houver comprometimento de artéria pulmonar principal e dos ramos lobares (e não dos ramos segmentares) 15 . O tromboembolismo pulmonar é uma condição clínica crítica e fatal, muitas vezes não diagnosticada, com grandes dificuldades no manejo, que requer tratamento rápido, e a melhora da terapêutica é necessária para diminuir a mortalidade 16,17 .…”

Angiojet System Used in the Treatment of Submassive Pulmonary Embolism: A Case Report of Two Patients

“…However, these therapies might be accompanied by complications such as bleeding and surgical complications. So, percutaneous mechanical thrombectomy (PMT) using a variety of devices has been developed [ 3 ]. Akam-Venkata et al [ 4 ] showed that catheter-directed therapy was an emerging alternative therapy for submassive and massive PE in children.…”