Aims: This retrospective study aimed to evaluate the therapeutic effects of AngioJet rheolytic thrombectomy system (ART) in treating severe acute pulmonary embolism (APE), including high-risk pulmonary embolism (HR-PE) and intermediate-high-risk pulmonary embolism (IHR-PE).
Methods and Results: Forty-four APE patients (21 HR-PE and 23 IHR-PE) were enrolled and underwent pulmonary ART using 6-French Solent Omini AngioJet device. Nineteen patients were diagnosed with APE and lower extremity deep venous thrombosis (LEDVT), and underwent thrombectomy of APE and LEDVT simultaneously using ART. All patients also received local thrombolysis with urokinase. The results showed that the mean length of stay in intensive care units was 2.4 ± 1.9 days. The significant improvement in clinical, hemodynamic and angiographic parameters were observed in both groups, and the improvements in shock index, PaO2, and angiographic parameters were improved more obviously in the IHR-PE group. Six of 44 patients died in-hospital. During the follow-up, 35 of 38 patients were functioning well and no recurrence of APE was observed.
Conclusions: Pulmonary ART plus local thrombolysis of the pulmonary artery for HR-PE or IHR-PE is feasible and appears to be safe. Further studies are warranted to investigate comparative efficacy compared to existing treatments.