Sex Differences in Outcomes of Percutaneous Pulmonary Artery Thrombectomy in Patients With Pulmonary Embolism

Agarwal, Manyoo; Dhaliwal, Jasmeet; Yang, Eric H.; Aksoy, Olcay; Press, Marcella Calfon; Watson, Karol E.; Ziaeian, Boback; Fonarow, Gregg C.; Moriarty, John M.; Saggar, Rajan; Channick, Richard N.

doi:10.1016/j.chest.2022.07.020

Cited by 8 publications

(5 citation statements)

References 48 publications

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“…However, the mortality rates for MT alone in the current analysis also appear lower than the 9.1%–13% in‐hospital mortality published in recent real‐world analyses of PE in the NIS and Nationwide Readmissions Database. 8 , 9 , 14 , 19 This may reflect variation in the populations in each database, the timeframes evaluated, and most likely differences in treatment categorization in each study (e.g., in‐hospital mortality in this analysis was 8%–17% when including patients receiving multiple treatments, including thrombolytics).…”

Section: Discussionmentioning

confidence: 99%

“…Rates of patient discharge to home in this analysis are similar to other published studies of MT at a national scale. 8 , 9 , 14 , 19 However, device‐level analysis enabled by the availability of CDM data identified patients receiving treatment with large‐bore volume‐controlled aspiration MT as 20%–40% more likely to be discharged to home. This may indicate a difference in perceived patient recovery depending on the MT device used for treatment.…”

Section: Discussionmentioning

confidence: 99%

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A cross‐sectional study of outcomes for patients undergoing mechanical thrombectomy for pulmonary embolism during 2018–2022: Insights from the PINC AI Healthcare Database

Gandhi,

Gibson,

Jaber

2024

Health Science Reports

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Background and AimsMechanical thrombectomy (MT) treatments for pulmonary embolism (PE) have yet to be compared directly. We aimed to determine if patient outcomes varied following treatment of PE with different MT devices.MethodsAll PE encounters with an index treatment of MT between January 2018 and March 2022 were analyzed for in‐hospital mortality, discharge to home, and 30‐day readmission outcomes in the PINC AI™ Healthcare Database. MT devices used in each encounter were extracted from hospital charge description free‐text fields using keyword text and fuzzy matching. Unadjusted and adjusted logistic regression was used to model outcomes by device.ResultsA total of 5893 encounters were identified using MT as the sole index PE treatment and 1812 using MT with another treatment. Of these, 41% had insufficient information to identify the devices used (unspecified MT), 33% used the FlowTriever System (large‐bore volume‐controlled aspiration MT), 23% the Indigo System (continuous aspiration MT), and 3% some other MT. Large‐bore volume‐controlled aspiration MT was used with other treatments 13% of the time compared with 23% and 39% for unspecified MT and continuous aspiration MT, respectively. Adjusted logistic regression modeling revealed the odds of in‐hospital mortality were significantly higher for patients treated with unspecified MT ([OR] = 1.42, 95% confidence interval [CI]: [1.10–1.83], p = 0.008) or continuous aspiration MT (OR = 1.63, 95% CI: [1.21–2.19], p = 0.001) compared with large‐bore volume‐controlled aspiration MT. Discharge to home was significantly lower in these same groups (OR = 0.84, 95% CI: [0.73–0.96], p = 0.01, and OR = 0.63, 95% CI: [0.53–0.74], p < 0.001, respectively), but readmission risks at 30 days were comparable (OR = 1.08, 95% CI: [0.84–1.38], p = 0.56, and OR = 1.20, 95% CI: [0.89–1.62], p = 0.24, respectively).ConclusionPE outcomes and treatment patterns differ significantly based on the type of MT utilized. Clinical studies directly comparing MT treatments are needed to further understand optimal treatment of PE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A cross‐sectional study of outcomes for patients undergoing mechanical thrombectomy for pulmonary embolism during 2018–2022: Insights from the PINC AI Healthcare Database

Gandhi,

Gibson,

Jaber

2024

Health Science Reports

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“…The incidence of pulmonary thromboembolism is higher in the female gender, 25 and the treatment availability and outcomes tend to be worse among females. [25][26][27] Hence, this method needs to be evaluated in a large patient population, including the female gender, for a better assessment of the results. These observations were made in a few numbers of patients only.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acute sub-massive pulmonary embolism with balloon angioplasty and thrombolysis simultaneously

Arokiaraj

2023

F1000Res

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Background: Acute sub-massive pulmonary embolism is a common clinical condition, and it is associated with high mortality and morbidity. This condition is commonly associated with various co-morbidities and clinical circumstances. Methods: This is a case report series of 4 patients, wherein the thrombolysis and balloon angioplasty was performed simultaneously using a Cordis 6F diagnostic catheter and later exchanged with a 6F guide catheter in the respective pulmonary artery when a larger balloon was required. Results: All these four patients achieved successful revascularization of the respective pulmonary artery. One patient expired 30 hours after the procedure with a significant reduction in the symptoms suddenly, which was likely a second episode of pulmonary embolism. No bleeding manifestations were observed in any of the patients. The other three patients are on follow-up. Conclusion: Simultaneous coronary balloon dilatation and thrombolysis is a useful method in the treatment of sub-massive acute pulmonary embolism. If needed, higher caliber balloons can be used for the same technique using guide catheters.

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“…Furthermore, women had 7.6% higher inhospital mortality as compared to men. 27 We do not understand why this difference in complication rate exists at this time.…”

Section: Pulmonary Embolism Interventionsmentioning

confidence: 90%

A Review of Healthcare Disparities Relevant to Interventional Radiology

Marchak,

Singh,

Malavia

et al. 2023

Semin intervent Radiol

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Racial, ethnic, and gender disparities have received focused attention recently, as they became more visible in the COVID era. We continue to learn more about how healthcare disparities manifest for our patients and, more broadly, the structural underpinnings that result in predictable outcomes gaps. This review summarizes what we know about disparities relevant to interventional radiologists. The prevalence and magnitude of disparities are quantified and discussed where relevant. Specific examples are provided to demonstrate how factors like gender, ethnicity, social status, geography, etc. interact to create inequities in the delivery of interventional radiology (IR) care. Understanding and addressing health disparities in IR is crucial for improving real-world patient outcomes and reducing the economic burden associated with ineffective and low-value care. Finally, the importance of intentional mentorship, outreach, education, and equitable distribution of high-quality healthcare to mitigate these disparities and promote health equity in interventional radiology is discussed.

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Sex Differences in Outcomes of Percutaneous Pulmonary Artery Thrombectomy in Patients With Pulmonary Embolism

Cited by 8 publications

References 48 publications

A cross‐sectional study of outcomes for patients undergoing mechanical thrombectomy for pulmonary embolism during 2018–2022: Insights from the PINC AI Healthcare Database

A cross‐sectional study of outcomes for patients undergoing mechanical thrombectomy for pulmonary embolism during 2018–2022: Insights from the PINC AI Healthcare Database

Treatment of acute sub-massive pulmonary embolism with balloon angioplasty and thrombolysis simultaneously

A Review of Healthcare Disparities Relevant to Interventional Radiology

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