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Semin Vasc Med 2001; 01(2): 247-252
DOI: 10.1055/s-2001-18494
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Transvenous Catheter Embolectomy

Guy Meyer1 , René Koning2 , Hervé Sors1
  • 1Service de Pneumologie-soins intensifs, Hôpital Européen Georges Pompidou, Paris V University, Paris, France
  • 2Service de cardiologie, Hôpital Charles Nicolle, University of Rouen, Rouen, France
Further Information

Publication History

Publication Date:
16 November 2001 (online)

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ABSTRACT

Transvenous pulmonary embolectomy was first described in 1969 by Greenfield and associates who designed a special catheter for the aspiration of thrombi in the pulmonary circulatory system. This technique was applied in 64 patients with massive pulmonary embolism (PE) with a 70 to 72% survival rate. However, it is difficult to implement and has not gained widespread acceptance. More recently, several other catheter devices have been used in patients with PE. The total number of patients reported does not exceed 100. Relative angiographic improvement varies between 10 and 49%, but hemodynamic improvement is not observed or not measured in most patients and mortality varies between 9 and 30%. Fibrinolysis was associated with mechanical thrombectomy in 54% of the patients, making the results difficult to interpret.

Transvenous pulmonary embolectomy remains an experimental procedure and should been attempted only in the very few patients with PE, uncontrolled cardiogenic shock, and absolute contraindication to fibrinolytic treatment. Animal models are required to compare the different devices available.

KEYWORD

Pulmonary embolism - embolectomy - thrombectomy - transvenous procedure

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