Mechanical clot fragmentation using a Swan-Ganz catheter is useful for acute massive pulmonary thromboembolism

Massive pulmonary thromboembolism (PE) is an acute-onset, life-threatening disease in the perioperative period. Massive PE led to severe hypoxemia and cor pulmonale in our patient who had undergone an operation for thalamic hemorrhage. Mechanical clot fragmentation using a Swan-Ganz catheter was attempted, because thrombolytic therapy was contraindicated for our patient. This procedure was successful, resulting in a decrease in pulmonary artery pressure with improvement in hypoxemia. Thus, this procedure may be useful for patients with massive PE with contraindications to thrombolytic therapy. <Learning objective: Here we present the usefulness of mechanical clot fragmentation using a Swan-Ganz catheter for a patient with massive pulmonary thromboembolism (PE) with contraindications to thrombolytic therapy. This case suggests that the procedure may be a promising method for reducing pulmonary artery pressure and improving hypoxemia in patients with massive PE.>.