Purpose: Aspiration thromboembolectomy is effective for treatment of high and intermediate-high risk pulmonary emboli (PE) but can be challenging when organized thrombus is present. Maceration using an expandable nitinol disk may be useful in these situations, but its safety has not been determined. The purpose of this study was to retrospectively assess the safety of this device when applied in the pulmonary vasculature, using a propensity-score matched group for comparison.
View Article and Find Full Text PDFPulmonary tumor thrombi are rare but challenging to treat given the generally poor health of the patients in whom they occur and the low likelihood of the embolism to respond to anticoagulation. Management options include therapeutic anticoagulation and surgery, but the mortality rate is high in either case. Thus, in patients who are symptomatic, the decision about whether to intervene may be challenging.
View Article and Find Full Text PDFPurpose: To evaluate the correlation between clot burden and pulmonary artery pressures in patients undergoing suction thromboembolectomy for high-risk and intermediate-high-risk pulmonary embolism with secondary outcomes of 30-day mortality and intensive care unit (ICU) length of stay.
Materials And Methods: Institutional review board (IRB) exemption was granted for this retrospective study. The charts of 120 consecutive patients who underwent mechanical thromboembolectomy using the Flowtriever system (Inari Medical, Irvine, California) between February 2020 and August 2022 were retrospectively reviewed, and the following data were collected: (a) preprocedural B-type natriuretic peptide and creatinine levels, (b) echocardiographic findings, (c) preprocedural and postprocedural pulmonary artery pressures, (d) ICU length of stay, and (e) 30-day mortality.
Objectives: To assess the effects of filtered blood reinfusion (FBR) on procedural outcomes of aspiration thrombectomy for pulmonary embolism (PE).
Materials And Methods: A total of 171 patients who underwent aspiration thrombectomy for intermediate-high-risk or high-risk PE between December 2018 and September 2022 were included, 84 of whom underwent thrombectomy with FBR and 87 without. Demographic data, vital signs, laboratory values, procedural details, pulmonary arterial pressures, transfusion needs, length of hospital stay, and procedure-related adverse events were recorded.
Despite considerable advances in surgical technique, many patients with hepatic malignancies are not operative candidates due to projected inadequate hepatic function following resection. Consequently, the size of the future liver remnant (FLR) is an essential consideration when predicting a patient's likelihood of liver insufficiency following hepatectomy. Since its initial description 30 years ago, portal vein embolization has become the standard of care for augmenting the size and function of the FLR preoperatively.
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