Bail‐out treatment of pulmonary embolism using a large‐bore aspiration mechanical thrombectomy device

Abstract

Abstract We report on the first pulmonary embolism treatment via the large‐bore aspiration mechanical thrombectomy device (Inari FlowTriever®) outside the USA, in a resuscitated patient on veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) suffering from severe and acute right heart failure. In this particular high‐risk patient population, where thrombolysis is mostly not applicable, this new technology could be a promising solution as the combination of large‐bore thrombus aspiration and extraction successfully removes large emboli. In our case, right ventricular function improved rapidly after the procedure, ECMO could be weaned, and the patient was dismissed 2 weeks after. In summary, we provide a new therapeutic option for the often difficult treatment of pulmonary embolism in high‐risk patients on VA‐ECMO.

Keywords

• Pulmonary embolism
• Large‐bore aspiration mechanical thrombectomy device
• FlowTriever
• Veno‐arterial ECMO