Pulmonary vascular disease & thromboembolismCohort study
Effect of large bore mechanical thrombectomy on pulmonary vascular resistance in patients with acute pulmonary embolism
- single-centre retrospective study
Authors' conclusion
In patients with intermediate-high risk PE, LBMT significantly reduced PVR and may be a valuable haemodynamic marker of disease severity and treatment response. Elevated post-procedural PVR identified patients at increased risk of adverse outcomes.
Study context
- Population
- Patients with intermediate-high risk pulmonary embolism (PE) undergoing large bore mechanical thrombectomy (LBMT) with pulmonary artery catheter-derived haemodynamic indices obtained pre- and post-procedure, October 2020-May 2025patients included
- Participants
- 131 patients
- Exposure
- Pulmonary vascular resistance (PVR) pre- vs post-LBMT; elevated vs non-elevated post-procedure PVR
- Outcome
- Effect of LBMT on PVR (median PVR)
- Follow-up
- Pre- and post-procedure
Main finding
As reported in the abstract
Median PVR decreased from 2.9 to 1.8 WU
P < 0.001
Reduction by baseline PVR tertile 3 to 1
50% vs. 40% vs. 20%; P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Multivariable predictors of elevated post-procedural PVR
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| pre-procedural mean pulmonary artery pressure | 1.07 (1.01–1.14) | P = 0.026 | |
| pre-procedural PVR | 2.20 (1.20–4.04) | P = 0.011 | |
| 0.20.5125Odds ratio (log scale) |
In-hospital length of stay (LOS)
| Comparison | difference (days) (95% CI) | P value | |
|---|---|---|---|
| elevated post-procedure PVR · longer with elevated post-procedure PVR · age and sex adjusted model | 4.2 (0.60–7.88) | P = 0.023 | |
| −50510Difference, days (linear scale) |
Composite outcome (PE mortality, resuscitated cardiac arrest, haemodynamic instability, and 90-day hospital readmission)
| Comparison | adjusted hazard ratio (95% CI) | P value | |
|---|---|---|---|
| elevated post-procedure PVR · 20.7% vs. 5.3% · age and sex adjusted model | 4.02 (1.28–12.61) | P = 0.017 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Persistently elevated post-procedure PVR (>2 WU)
- Share of patients
- 44%
Severe PVR >5 WU
- pre-procedure
- 11.5%
- post-procedure
- 0.8%
Original publication
Summarised from the published abstract; every number is checked against it