関連する実験動画

Updated: Feb 7, 2026

A Porcine Model of Acute Autologous Pulmonary Embolism

A Porcine Model of Acute Autologous Pulmonary Embolism

Published on: September 6, 2024

PFOと肺塞栓症を伴う卵円孔開存を介した塞栓前兆を伴う血栓移動症に対するICEガイド下経皮的血栓摘除術

Timothy Ho Him Kam¹, Cheuk Yin Lai¹, Leo Kar Lok Lai¹

¹Division of Cardiology, Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong, China.

JACC. Case reports

|February 5, 2026

要旨

Objective:

Impending paradoxical embolism (IPE), defined as thrombus entrapped across a patent foramen ovale, is rare in acute pulmonary embolism (PE) and is associated with high mortality. We present to our knowledge the first successful intracardiac echocardiography (ICE)-guided mechanical thrombectomy for simultaneous treatment of right ventricular thrombus-in-transit (TIT), IPE, and high-risk PE.

Key Steps:

ICE was used to locate the mobile TIT straddling the patent foramen ovale. For embolic protection, a Sentinel cerebral protection system was deployed via the right radial artery, while a blocking balloon positioned in the left subclavian artery. A 24-F femoral venous access enabled advancement of the AlphaVac F18⁸⁵ system into the right atrium. Under ICE guidance, aspiration evacuated the TIT and IPE, followed by catheter-based pulmonary thrombectomy.

Potential Pitfalls:

Percutaneous thrombectomy is feasible for patients unsuitable for surgery or thrombolysis but carries a risk of paradoxical embolization. Embolic protection is therefore essential.

Take-Home Message:

ICE-guided AlphaVac thrombectomy of TIT, IPE, and PE is feasible in high-risk patients.

キーワード:

塞栓前兆心腔内心エコー卵円孔開存経皮的血栓摘除術肺塞栓症移動血栓

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