Catheter Thrombectomy of Massive Pulmonary Embolism Secondary to Spongostan Embolisation: A Case Report

Novel adjuvant hemostatic agents are increasingly used in surgical procedures to achieve hemostasis. We present a case of embolisation of hemostatic agents during a neurosurgical operation, causing massive PE requiring venoarterial extracorporeal membrane oxygenation support, in a 7-year-old boy. Embolectomy was performed using the Penumbra 0.072" catheter with aspiration of blood clots alongside gelatinous clumps of Spongostan and thrombin, leading to angiographic and clinical improvement. A Cook MPA angiographic 5FR catheter and Terumo 0.035" wire were used for catheter repositioning between aspiration attempts. The following day, the patient was weaned from extracorporeal membrane oxygenation, and a day later, he underwent successful extubation. Catheter embolectomy with the Penumbra System can provide safe, rapid relief to a failing right ventricle in cases of massive PE caused by Spongostan.