Catheter-Directed Thrombectomy for Pulmonary Embolism in the Setting of Acute Stroke

Abstract

A 79-year-old male presented with an acute stroke and was treated with tissue plasminogen activator (tPA). His neurological symptoms improved, but he subsequently developed hemodynamic instability requiring intubation and vasopressors. Imaging studies revealed a massive pulmonary embolism as the cause of his worsening clinical picture. Mechanical thrombectomy using traditional devices was deemed too risky as the patient could not safely tolerate the usual anticoagulation dosage these devices require. The Penumbra Indigo® system (Alameda, CA, USA) was thus chosen for its ability to achieve thrombus aspiration within a lower therapeutic heparin range. Pulmonary artery aspiration thrombectomy was done using the device, and three days after the procedure, he was extubated and weaned completely off vasopressors. The therapy's efficacy despite the patient's unique life-threatening conditions demonstrates a novel application of the state-of-the-art pulmonary embolism treatment currently in research.

Effect of Solitaire FR Stent Thrombectomy Combined with the Suction Thrombus on the Clinical Effect and Prognosis of Acute Middle Cerebral Artery Occlusion

“…The Penumbra thrombus suction system was approved by the US FDA in December 2007 and launched in 2008. It mainly contacts the proximal surface of the thrombus and gently sucks the thrombus in the intracranial blood vessels [ 17 ]. In the present research, the vascular recanalization rate in the suction group and Solitaire FR group was 82.5% and 100%, respectively, r indicating that the Solitaire FR stent + suction thrombus for AMCAO has advantages in vascular recanalization.…”