Clinical guidelines support the use of systemic thrombolytic therapy for acute massive pulmonary embolism (PE). When anticoagulation and thrombolysis fail or are contraindicated, options become limited. We report an acute PE case in which treatment options were limited, and a novel device, the FlowTriever (Inari Medical, Irvine, California), was successfully used. This is the first case report of the use of this device that we are aware of.
NassiriNJainAMcPheeD. Massive and submassive pulmonary embolism: experience with an algorithm for catheter-directed mechanical thrombectomy. Ann Vasc Surg. 2012;26(1):18–24.
2.
KucherN. Catheter embolectomy for acute pulmonary embolism. Chest. 2007;132(2):657–663.
3.
AntmanEMAnbeDTArmstrongPW. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). J Am Coll Cardiol. 2004;44(3):E1–E211.
4.
KuoWTvan den BoschMAHofmannLVLouieJDKotharyNSzeDY. Catheter-directed embolectomy, fragmentation, and thrombolysis for the treatment of massive pulmonary embolism after failure of systemic thrombolysis. Chest. 2008;134(2):250–254.
5.
LayishDTTapsonVF. Pharmacologic hemodynamic support in massive pulmonary embolism. Chest. 1997;111(1):218–224.
6.
SkafEBeemathASiddiquiTJanjuaMPatelNRSteinPD. Catheter-tip embolectomy in the management of acute massive pulmonary embolism. Am J Cardiol. 2007;99(3):415–420.
7.
MorrisTAMarshJJChilesPGAugerWRFedulloPFWoodsVLJr. Fibrin derived from patients with chronic thromboembolic pulmonary hypertension is resistant to lysis. Am J Respir Crit Care Med. 2006;173(11):1270–1275.
8.
PiazzaGGoldhaberSZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2011;364(4):351–360.
9.
PengoVLensingAWPrinsMH; Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350(22):2257–2264.
10.
KucherNBoekstegersPMüllerOJ. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation. 2014;129(4):479–486.
11.
PiazzaGHohlfelderBJaffMR; SEATTLE II Investigators. A prospective, single-arm, multicenter trial of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis for acute massive and submassive pulmonary embolism: the SEATTLE II study. JACC Cardiovasc Interv. 2015;8(10):1382–1392.
12.
KearonCAklEAComerotaAJ; American College of Chest Physicians. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 suppl):e419S–e494S.
