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Updated: Jun 5, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Balloon catheter pulmonary embolectomy under direct visual control using a choledochoscope.

Koji Kawahito¹, Hideo Adachi

¹Department of Cardiac Surgery, Jikei University School of Medicine, Kashiwa Hospital, Kashiwa, Japan. kj_kawahito@msn.com

The Annals of Thoracic Surgery

|January 25, 2011

Summary

This study introduces a novel technique for acute massive pulmonary embolism using balloon catheter embolectomy with a flexible choledochoscope. This method enables complete clot extraction, improving outcomes for critically ill patients.

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Last Updated: Jun 5, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Area of Science:

Cardiovascular Surgery
Pulmonary Medicine
Interventional Cardiology

Background:

Acute massive pulmonary embolism (PE) carries a high mortality rate, necessitating advanced therapeutic strategies.
Effective clot removal without damaging pulmonary arteries is crucial for patient survival.

Purpose of the Study:

To evaluate the efficacy of balloon catheter embolectomy guided by a flexible choledochoscope for treating acute massive pulmonary embolism.
To assess the feasibility of achieving complete clot extraction in critically ill PE patients.

Main Methods:

Balloon catheter embolectomy was performed under direct visual guidance using a flexible choledochoscope.
Deep hypothermic circulatory arrest was employed to enhance visualization.
Cold normal saline solution was utilized for irrigation during the procedure.

Main Results:

The choledochoscope facilitated clear visualization of the pulmonary vasculature.
The technique allowed for effective access to secondary and tertiary pulmonary arterial branches.
Complete clot extraction was successfully achieved in the treated cases.

Conclusions:

Balloon catheter embolectomy with a flexible choledochoscope is a viable and effective method for managing acute massive pulmonary embolism.
This minimally invasive approach offers improved visualization and complete clot removal, potentially reducing mortality in high-risk PE patients.