Unleashing the Blood Clots: Revolutionizing Acute Pulmonary Thromboembolism Management With Endovascular Techniques

Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), are the leading causes of mortality and morbidity worldwide. Embolization of deep vein thrombi into the pulmonary arteries is thought to be the most common cause of PE. While the standard management of acute PE involves anticoagulation, mechanical thrombectomy, and, in certain cases, the use of inferior vena cava (IVC) filters, clinical scenarios with contraindications to anticoagulation necessitate alternative therapeutic approaches. We present the case of a 77-year-old female who presented with acute PE and multiple comorbidities, including active hematuria. The patient was successfully managed by mechanical thrombectomy using the Penumbra Indigo^® Aspiration System (Penumbra Inc., Alameda, CA) and subsequently underwent temporary implantation of an IVC filter to prevent the risk of recurrence. This case contributes to advancing current knowledge in the management of acute PE, particularly in frail, elderly patients with multiple comorbidities, and reinforces the critical role of personalized, multi-modal therapeutic approaches in improving survival rates.