Acute cardiac care & resuscitation
Percutaneous large-bore aspiration embolectomy with veno-arterial extracorporal membrane oxygenation support or standby in patients with high-risk pulmonary embolism and contraindications to thrombolysis: a preliminary single centre experience
Authors' conclusion
This study provides preliminary evidence for the feasibility of percutaneous large-bore aspiration embolectomy in combination with VA-ECMO support (or standby) in patients with high-risk PE and contraindications to thrombolysis.
Study context
- Population
- Acute high-risk pulmonary embolism (PE) with contraindications to thrombolysis, University Hospital Zurich, April 2021–August 2022mean age 63.1 years
- Participants
- 15 participants
- Outcome
- Composite of:
- Recurrent PE
- HF hospitalization
- All-cause death
- Follow-up
- 30 days
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Recurrent PE, HF hospitalization or all-cause death
Primary outcome at 30 days, n
5 (33.3%; 95% CI 13.0-61.3%) (%; 95% CI)
Observational data: associations, not effects.
Further findings
Presentation
- Cardiac arrest
- 4 (27%)
- Ongoing obstructive shock
- 8 (53%)
- Persistent arterial hypotension
- 3 (20%)
Veno-arterial extracorporal membrane oxygenation (VA-ECMO) use and weaning
- VA-ECMO implanted before embolectomy
- 8 (53%)
- Periprocedural cardiac arrest without initial VA-ECMO
- 3 of 7
- ECMO started before completion of embolectomy among those
- 2
- Successful VA-ECMO weaning
- all patients
- Mean time to weaning
- 5.4 days
Periprocedural death
- Periprocedural death (patient without VA-ECMO support after periprocedural cardiac arrest)
- 1
Original publication
Percutaneous large-bore aspiration embolectomy with veno-arterial extracorporal membrane oxygenation support or standby in patients with high-risk pulmonary embolism and contraindications to thrombolysis: a preliminary single centre experience. Eur Heart J Acute Cardiovasc Care. Published 24 February 2023. doi:10.
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