Interventional therapy and its effectiveness for acute massive pulmonary thromboembolism

Objective: To evaluate the effectiveness and safety of interventional embolectomy in the treatment of acute massive pulmonary embolism. Methods: Interventional managements, including fragmentation, aspiration and dissolving of the embolus, were performed in 12 patients with CTPA-or pulmonary angiography-proved acute massive pulmonary embolism. Clinical manifestations, blood gas tension, hemodynamic changes, the recanalization of the pulmonary artery as well as the occurrence of complications were observed. Results: Eleven patients survived and nine patients showed significant clinical improvement. PaO2 was increased from (54.92±6.17)mmHg before the procedure to (90.91±1.62)mmHg after the procedure (P=0.001), and SaO2 was also increased from (85.17±8.39)mmHg before the procedure to (95.75±1.96)mmHg after the procedure (P=0.001). Miller score (21.75±4.35 vs 13.83± 5.69, P=0.001) and mPAP (25.59±7.68 mmHg vs 30.04±7.93 mmHg, P=0.001)decreased significantly. One patient died of pulmonary embolism and one died of intracerebral bleeding three days after the procedure. Conclusion: Interventional embolectomy is an effective and safe technique for the treatment of acute massive pulmonary embolism. (authors)