VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism
BackgroundPercutaneous mechanical thrombectomy (PMT) is increasingly used in the treatment of intermediate and high-risk acute pulmonary embolism (PE), and the treatment of high-risk PE with the aid of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has also been reported. However, there...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| author | Zhenhang Zhou Zhenhang Zhou Zhenhang Zhou Yaoyang Zhong Yaoyang Zhong Yaoyang Zhong Jianbo Hu Jianbo Hu Jianbo Hu Zhonghua Wu Zhonghua Wu Zhonghua Wu Liping Zou Liping Zou Liping Zou Zhihe Deng Zhihe Deng Zhihe Deng Guoshan Bi Guoshan Bi Guoshan Bi Xin Shen Xin Shen Xin Shen Xianpeng Dai Xianpeng Dai Xianpeng Dai Zhijia Huang Guozuo Xiong Guozuo Xiong Guozuo Xiong Yiming Xu Liming Deng Liming Deng Liming Deng |
| author_facet | Zhenhang Zhou Zhenhang Zhou Zhenhang Zhou Yaoyang Zhong Yaoyang Zhong Yaoyang Zhong Jianbo Hu Jianbo Hu Jianbo Hu Zhonghua Wu Zhonghua Wu Zhonghua Wu Liping Zou Liping Zou Liping Zou Zhihe Deng Zhihe Deng Zhihe Deng Guoshan Bi Guoshan Bi Guoshan Bi Xin Shen Xin Shen Xin Shen Xianpeng Dai Xianpeng Dai Xianpeng Dai Zhijia Huang Guozuo Xiong Guozuo Xiong Guozuo Xiong Yiming Xu Liming Deng Liming Deng Liming Deng |
| author_sort | Zhenhang Zhou |
| collection | DOAJ |
| description | BackgroundPercutaneous mechanical thrombectomy (PMT) is increasingly used in the treatment of intermediate and high-risk acute pulmonary embolism (PE), and the treatment of high-risk PE with the aid of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has also been reported. However, there are few reports of VA-ECOM-assisted PMT in the treatment of high-risk PE. The purpose of this study is to summarize the data of 11 patients with high-risk PE treated with VA-ECMO assisted PMT, and propose feasible treatment methods for such patients.MethodsThis multicenter retrospective study included patients with acute high-risk PE who were treated with VA-ECMO-assisted PMT from January 2021 to June 2024. The analysis focused on the right/left ventricle ratio, biomarkers, and pulmonary artery pressure before and after the VA-ECMO-assisted PMT treatment.ResultsAll 11 high-risk PE patients suffered cardiac arrest before treatment, computered tomograhy pulmonary angiography (CTPA) confirmed the diagnosis of PE, and all patients received VA-ECMO-assisted PMT therapy. The median age of the 11 patients was 54 years (range 18–72), the median duration of ECMO was 4.48 days (range 1.04–18.02), and the mean hospitalization time was 21 days (range 14–112). All patients received percutaneous thrombectomy, achieving a 100% technical success rate. The mortality rate was 27.3% during the 90-day follow-up. The 12-month mortality rate was 36.4%.ConclusionVA-ECMO-assisted PMT technology can rapidly improve pulmonary hemodynamics while maintaining stable blood flow, thereby reducing in-hospital mortality in high-risk patients with pulmonary embolism complicated by cardiac arrest. |
| format | Article |
| id | doaj-art-3ba24e32a40142c68a69ae3b04486769 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-3ba24e32a40142c68a69ae3b044867692024-12-24T06:36:56ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.14571571457157VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolismZhenhang Zhou0Zhenhang Zhou1Zhenhang Zhou2Yaoyang Zhong3Yaoyang Zhong4Yaoyang Zhong5Jianbo Hu6Jianbo Hu7Jianbo Hu8Zhonghua Wu9Zhonghua Wu10Zhonghua Wu11Liping Zou12Liping Zou13Liping Zou14Zhihe Deng15Zhihe Deng16Zhihe Deng17Guoshan Bi18Guoshan Bi19Guoshan Bi20Xin Shen21Xin Shen22Xin Shen23Xianpeng Dai24Xianpeng Dai25Xianpeng Dai26Zhijia Huang27Guozuo Xiong28Guozuo Xiong29Guozuo Xiong30Yiming Xu31Liming Deng32Liming Deng33Liming Deng34Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaDepartment of Vascular Surgery, Zhongshan Hospital Xiamen University, Xiamen, Fujian, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaHunan Province Thrombotic Disease Prevention and Treatment Clinical Medical Research Center, Hengyang, Hunan, ChinaHunan Provincial Key Clinical Specialty, Hengyang, Hunan, ChinaBackgroundPercutaneous mechanical thrombectomy (PMT) is increasingly used in the treatment of intermediate and high-risk acute pulmonary embolism (PE), and the treatment of high-risk PE with the aid of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has also been reported. However, there are few reports of VA-ECOM-assisted PMT in the treatment of high-risk PE. The purpose of this study is to summarize the data of 11 patients with high-risk PE treated with VA-ECMO assisted PMT, and propose feasible treatment methods for such patients.MethodsThis multicenter retrospective study included patients with acute high-risk PE who were treated with VA-ECMO-assisted PMT from January 2021 to June 2024. The analysis focused on the right/left ventricle ratio, biomarkers, and pulmonary artery pressure before and after the VA-ECMO-assisted PMT treatment.ResultsAll 11 high-risk PE patients suffered cardiac arrest before treatment, computered tomograhy pulmonary angiography (CTPA) confirmed the diagnosis of PE, and all patients received VA-ECMO-assisted PMT therapy. The median age of the 11 patients was 54 years (range 18–72), the median duration of ECMO was 4.48 days (range 1.04–18.02), and the mean hospitalization time was 21 days (range 14–112). All patients received percutaneous thrombectomy, achieving a 100% technical success rate. The mortality rate was 27.3% during the 90-day follow-up. The 12-month mortality rate was 36.4%.ConclusionVA-ECMO-assisted PMT technology can rapidly improve pulmonary hemodynamics while maintaining stable blood flow, thereby reducing in-hospital mortality in high-risk patients with pulmonary embolism complicated by cardiac arrest.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1457157/fullpulmonary embolismcardiogenic shockVA-ECOMpercutaneous mechanicalprognosis |
| spellingShingle | Zhenhang Zhou Zhenhang Zhou Zhenhang Zhou Yaoyang Zhong Yaoyang Zhong Yaoyang Zhong Jianbo Hu Jianbo Hu Jianbo Hu Zhonghua Wu Zhonghua Wu Zhonghua Wu Liping Zou Liping Zou Liping Zou Zhihe Deng Zhihe Deng Zhihe Deng Guoshan Bi Guoshan Bi Guoshan Bi Xin Shen Xin Shen Xin Shen Xianpeng Dai Xianpeng Dai Xianpeng Dai Zhijia Huang Guozuo Xiong Guozuo Xiong Guozuo Xiong Yiming Xu Liming Deng Liming Deng Liming Deng VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism Frontiers in Cardiovascular Medicine pulmonary embolism cardiogenic shock VA-ECOM percutaneous mechanical prognosis |
| title | VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism |
| title_full | VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism |
| title_fullStr | VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism |
| title_full_unstemmed | VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism |
| title_short | VA-ECOM assisted percutaneous mechanical thrombectomy treatment high-risk pulmonary embolism |
| title_sort | va ecom assisted percutaneous mechanical thrombectomy treatment high risk pulmonary embolism |
| topic | pulmonary embolism cardiogenic shock VA-ECOM percutaneous mechanical prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1457157/full |
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