Bail-out treatment of pulmonary embolism using a large-bore aspiration mechanical thrombectomy device

We report on the first pulmonary embolism treatment via the large-bore aspiration mechanical thrombectomy device (Inari FlowTriever®) outside the USA, in a resuscitated patient on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) suffering from severe and acute right heart failure. In this particular high-risk patient population, where thrombolysis is mostly not applicable, this new technology could be a promising solution as the combination of large-bore thrombus aspiration and extraction successfully removes large emboli. In our case, right ventricular function improved rapidly after the procedure, ECMO could be weaned, and the patient was dismissed 2 weeks after. In summary, we provide a new therapeutic option for the often difficult treatment of pulmonary embolism in high-risk patients on VA-ECMO.