Catheter-Directed Mechanical Thrombectomy in Massive Pulmonary Embolism With Cardiogenic Shock

Jayanna, Manju Bengaluru; Ahmad, Tariq; Maalouf, Marc; Omondi, Arthur; Bobby, DO Rachel; Caroline, Mara; Gnall, DO Eric M.

doi:10.1016/j.jaccas.2020.04.031

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…This approach specifically provides the advantages of percutaneous implantation including the possibility of patient’s mobilization as well as bedside explantation. These findings are in line with a case recently presented by Jayanna et al 10 This patient with cardiogenic shock secondary to massive pulmonary embolism and right ventricular failure was managed with catheter-directed thrombectomy and temporary ProtekDuo support, which led to complete recovery. In addition, Oliveros and coworkers collected retrospective data of consecutive patients who received a ProtekDuo device for acute RV failure over a 3-year period.…”

Section: Configurations Technical Aspects and Present Evidencesupporting

confidence: 91%

The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

et al. 2022

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The ProtekDuo, single site dual lumen cannula can be used in a multitude of configurations. In the medical literature, the ProtekDuo is described as right ventricular assist device (RVAD), as left ventricular assist device (LVAD), as biventricular assist device (BiVAD) when combined with an Impella device or other LVAD’s, as double lumen drainage cannula on cardiopulmonary bypass (CPB), as RVAD with oxygenator, in veno-pulmonary (V-P) ECMO configuration, venovenous-pulmonary (VV-P) ECMO configuration with additional drainage cannula, and in veno-venopulmonary (V-VP) ECMO configuration as double lumen return cannula. Improvements in flow and oxygenation have been recognized in various settings and need further scientific evaluation. We summarized the above-mentioned configurations, technical aspects, and the present literature available for the ProtekDuo.

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Section: Configurations Technical Aspects and Present Evidencesupporting

confidence: 91%

The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

et al. 2022

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“…Jayanna and colleagues described a case of a 72-year-old with Adaptive ECMO Therapeutics: The Integral Role of the ProtekDuo® Cannula DOI: http://dx.doi.org/10.5772/intechopen.1005327 massive PE who, following treatment with intravenous UFH and catheter-based embolectomy, developed hypoxic respiratory failure secondary to hemoptysis and sustained cardiogenic shock due to RVF. The patient received VP ECMO in a (dl) V-P configuration using the ProtekDuo® cannula, ultimately surviving to hospital discharge with restored RV function [41].…”

Section: Application Of Protekduo® For Vp Ecmo In Cardiogenic Shockmentioning

confidence: 99%

Adaptive ECMO Therapeutics: The Integral Role of the ProtekDuo® Cannula

Brewer,

Dacey,

O. Maybauer

2024

Evolving Therapies and Technologies in Extracorporeal Membrane Oxygenation [Working Title]

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This chapter provides an in-depth analysis of the ProtekDuo® (LivaNova, London) dual-lumen cannula’s application in extracorporeal membrane oxygenation (ECMO), focusing on the procedural techniques of cannulation, weaning, and decannulation. The discussion will provide the step-by-step methodologies for inserting and removing the cannula, drawing from current clinical practices. Further, the chapter will explore the range of ECMO configurations that the ProtekDuo® cannula enables. It will examine how these configurations can be tailored to the evolving clinical requirements of patients, thereby enhancing the adaptability and effectiveness of ECMO therapy. This analysis will be anchored in the latest literature, providing a contemporary overview of patient outcomes and current practices. Lastly, the chapter will project into the future of the cannula technology for venopulmonary (VP) ECMO and other configurations. It will review ongoing research and development efforts, speculate on potential technological breakthroughs, and discuss the implication of these innovations for clinical practice. This forward-looking perspective will aim to inform and inspire continued advancement in ECMO therapy and technology.

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“…Jayanna et al published a case report about a 72-year-old woman who presented to the emergency department in cardiogenic shock due to a massive PE and RVF ( 29 ). After undergoing catheter-directed mechanical thrombectomy, the patient’s RV function did not improve, and a ProtekDuo RV MCS was inserted.…”

Section: Protekduo For Massive Pementioning

confidence: 99%

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

John,

Nabzdyk,

Chweich

et al. 2024

Ann Transl Med

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The ProtekDuo (LivaNova, London, UK) cannula is a dual-lumen device, typically inserted into the right internal jugular (IJ) vein through a percutaneous approach, with fluoroscopy or ultrasound guidance. When connected to a pump, such as the TandemHeart (LivaNova, London, UK) or CentriMag (Abbott, Pleasanton, CA, USA), it can function as a right ventricular (RV) mechanical circulatory support (MCS). When an oxygenator is also added [veno-pulmonary (V-P)], it can provide extracorporeal membrane oxygenation (ECMO) support. This review aims to provide a comprehensive overview of the device’s physiology and clinical applications. In the setting of RV failure (RVF), the ProtekDuo cannula, with its outflow in the main pulmonary artery (PA), can bypass the failing RV, improving pulmonary flow, left atrial (LA) filling pressures, and left ventricular (LV) preload. This can also reduce ventricular interdependence and leftward shift of the interventricular septum that occurs in RVF. In this review, the key sections expand on the use of the ProtekDuo cannula in the management of critically ill patients, specifically, the use of ProtekDuo for RV myocardial infarction (MI) RVF, LV assist device (LVAD) implantation-associated RVF, RVF post-heart transplantation, temporary biventricular MCS as bridge to recovery (ECpella 2.0 or PROpella), biventricular support as bridge to recovery or decision, isolated LV failure, post lung transplantation (LT) care, and other miscellaneous clinical scenarios. ProtekDuo is an important tool in the armory of RVF management. The ProtekDuo system is expected to gain more popularity given its clear advantages such as groin-free approach allowing for mobility, easy percutaneous deployment, compatibility with various pumps and oxygenators, and the versatility to be integrated in numerous configurations. In an era of expanding MCS options, further research is needed to better understand the optimal tool for specific patient subsets.

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Catheter-Directed Mechanical Thrombectomy in Massive Pulmonary Embolism With Cardiogenic Shock

Cited by 5 publications

References 9 publications

The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

Adaptive ECMO Therapeutics: The Integral Role of the ProtekDuo® Cannula

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

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