Early experience with the FlowTriever thrombectomy system to treat pulmonary embolism

• Published in: REC, Interventional cardiology (Internet. English ed.) Vol. 5; no. 2; pp. 142 - 150
• Main Authors: Salinas, Pablo, Vázquez-Álvarez, María-Eugenia, Jurado-Román, Alfonso, and, Sílvio Leal, Huanca, Mike
• Format: Journal Article
• Language: English
• Published: Permanyer 01.04.2023
• ISSN: 2604-7322; 2604-7322
• DOI: 10.24875/RECICE.M22000354

To the Editor, Catheter-directed therapy is indicated in high-risk patients (PE-HR) to treat pulmonary embolism (PE) when systemic thrombolysis is contraindicated or has failed (indication IIA, C). Also, as a bailout therapy in intermediate/high-risk patients (PE-IHR) with hemodynamic impairment as an alternative to systemic thrombolysis (indication IIA, C).1 However, clinical practice guidelines do not specify which is the optimal catheter-directed therapy that should be used. It can be local thrombolysis that consists of the direct infusion of variable doses (around 20% of systemic dose) of thrombolytic drugs (alteplase or tenecteplase) into the pulmonary artery (intra-thrombus) or else mechanical thrombectomy with direct aspiration catheter that consists of thrombus extraction (with or without previous fragmentation). Finally, a mechanical-pharmacological strategy with both techniques combined can be used sequentially.2 This is the early experience of mechanical thrombectomy with direct aspiration using the FlowTriever retrieval/aspiration system (Inari, United States) of 4 Spanish and Portuguese centers. The Hospital Clínico San Carlos ethics committee approved the registry and obtained the participants' written informed consent. The FlowTriever is a 24-Fr thrombus aspiration system with an oversized tube and accessories to optimize thrombus extraction.3,4 These are 3 cases of PE-HR with contraindication for systemic thrombolysis and 7 cases of PE-IHR treated...