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Percutaneous mechanical thrombectomy using the AcoStream thrombus aspiration system for intermediate-high-risk
Jun Lu1, Xing-Hua Zhang1, Xiao-Hua Guo1
1Department of Oncology and Vascular Intervention, Jinhua Municipal Central Hospital, Jinhua, China.
Journal of Thoracic Disease
|August 12, 2026
Summary
Mechanical thrombectomy using the AcoStream system shows promising results for intermediate-high-risk pulmonary embolism (PE), significantly improving patient hemodynamics and gas exchange with a low bleeding risk.
Area of Science:
- Cardiology
- Interventional Radiology
- Pulmonary Medicine
Background:
- Intermediate-high-risk pulmonary embolism (PE) poses a significant risk of deterioration.
- Catheter-directed thrombolysis (CDT) is effective but carries bleeding risks.
- Mechanical thrombectomy (MT) is a promising alternative requiring validation.
Purpose of the Study:
- To evaluate the efficacy and safety of AcoStream mechanical thrombectomy for acute intermediate-high-risk PE.
- To assess short-term improvements in hemodynamic and physiological parameters.
- To determine the incidence of bleeding complications.
Main Methods:
- Retrospective analysis of 45 patients with acute intermediate-high-risk PE undergoing AcoStream MT.
- Evaluation of immediate and early improvements in Miller index, pulmonary artery systolic pressure (PASP), and gas exchange.
- Assessment of safety outcomes including major bleeding and clinically relevant non-major bleeding (CRNMB) per ISTH criteria.
Main Results:
- Significant reduction in Miller index (16 to 6) and PASP (46 to 30 mmHg).
- Profound improvements in PaO2/FiO2 ratio (260 to 381), heart rate (104 to 80 bpm), and lactate levels (1.9 to 1.5 mmol/L).
- No major bleeding events; 6.7% CRNMB managed conservatively.
Conclusions:
- AcoStream MT demonstrates favorable short-term procedural and hemodynamic outcomes in intermediate-high-risk PE.
- Findings are hypothesis-generating due to observational design.
- Larger prospective studies are needed for confirmation.
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