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Catheter directed interventions for pulmonary embolism: current status and future prospects
Adham N Abou Ali1, Zein Saadeddin1, Rabih A Chaer1
1Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Expert Review of Medical Devices
|January 16, 2020
Summary
Catheter directed interventions (CDIs) offer an alternative to systemic thrombolysis for acute pulmonary embolism (PE), reducing complications while maintaining efficacy. These advanced techniques are crucial for managing high-risk PE patients.
Area of Science:
- Interventional Cardiology
- Pulmonary Medicine
- Vascular Surgery
Background:
- Systemic thrombolysis for acute pulmonary embolism (PE) carries significant bleeding risks.
- Catheter directed interventions (CDIs) have emerged as a less invasive alternative.
- CDIs aim to provide comparable therapeutic benefits with reduced complications.
Purpose of the Study:
- To provide a contemporary review of available CDIs for acute PE.
- To summarize indications, technical aspects, effectiveness, and outcomes of CDIs.
- To offer expert opinion on CDI selection for different PE risk strata.
Main Methods:
- Review of current catheter directed interventions for acute PE.
- Inclusion of ultrasound-guided catheters, multi-side hole infusion catheters, and suction thrombectomy systems.
- Analysis of clinical effectiveness, complication rates, and long-term outcomes.
Main Results:
- CDIs encompass diverse technologies for acute PE treatment.
- Evidence supports CDIs as a viable option for selected PE patients.
- Specific CDI techniques show promise in managing high-risk PE.
Conclusions:
- CDIs should be considered for intermediate-high risk PE patients at risk of decompensation, especially if thrombolysis is contraindicated.
- Suction thrombectomy is a valuable option for high-risk PE patients with absolute contraindications to thrombolysis, provided expertise is available.
- CDIs represent an evolving and important therapeutic avenue for acute PE management.
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