Late clinical outcomes of manual aspiration thrombectomy for a massive acute pulmonary thromboembolism
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ORIGINAL ARTICLE
Late clinical outcomes of manual aspiration thrombectomy for a massive acute pulmonary thromboembolism Hiroyuki Tajima1,2 · Tatsuo Ueda3 · Takahiko Mine3 · Shiro Onozawa4 · Satoru Murata4 Received: 29 January 2020 / Accepted: 30 September 2020 © Japan Radiological Society 2020
Abstract Purpose We investigated the late outcomes of patients who underwent manual aspiration thrombectomy for acute massive pulmonary thromboembolism. Materials and methods Fifteen patients underwent manual aspiration thrombectomy between December 1995 and June 2002. All patients were discharged after the procedure. Patients’ statuses were checked by medical record examinations and telephone interviews. The median follow-up was 162 months (116–208 months). Results Five patients died during follow-up; two for malignancy, one for septic shock, one for cerebral infarction, and in one patient the cause of death was unknown. There were no pulmonary thromboembolism-related deaths during the period and no recurrence. The 1-year survival rate was 100%, the 5-year survival rate was 75.0 ± 12.5%, and the 10-year survival rate was 75.0 ± 12.5%. Conclusion Patients who undergo manual aspiration thrombectomy for acute massive pulmonary thromboembolism show acceptable outcomes. Keywords Intervention · Pulmonary embolism · Long-term result
Introduction Acute massive pulmonary thromboembolism is a lifethreatening condition, and the 30-day mortality rate shows 16–25% [1, 2]. When patients survive long enough to have a diagnosis of massive PTE and start receiving treatment, the outcome is considered to be moderately good, early diagnosis and immediate therapy is important. The standard therapy of pulmonary thromboembolism is anticoagulation, and supportive treatment such as systemic thrombolysis and * Hiroyuki Tajima h‑[email protected]; htajima@saitama‑med.ac.jp 1
Center for Minimally Invasive Treatment, Nippon Medical School Musashikosugi Hospital, 1‑396, Kosugi‑cho, Nakahara‑ku, Kawasaki City, Kanagawa 211‑8533, Japan
2
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397‑1, Yamane, Hidaka City, Saitama 350‑1298, Japan
3
Department of Radiology, Nippon Medical School, Tokyo, Japan
4
Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
surgical embolectomy is vital in patients with right ventricular and respiratory failure [1, 2]. Long-term outcome of acute massive pulmonary thromboembolism following thrombolysis and surgical embolectomy have been shown [3–6]. Catheter interventions also have been introduced in this area, including catheter-directed thrombolysis and catheter-assisted thrombus removal [7], and early outcomes were clear [8]. Surgical intervention is only justified after the long-time mortality becomes evident. Furthermore, development of chronic thromboembolic pulmonary hypertension is the current problem after acute phase. However, the late mortality rates associated with catheter intervention have not yet been reported. The objectiv
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