Details

Autor(en) / Beteiligte

• Zhang, Robert S
• Alviar, Carlos L
• Yuriditsky, Eugene
• Alam, Usman
• Zhang, Peter S
• Elbaum, Lindsay
• Grossman, Kelsey
• Singh, Arushi
• Maqsood, Muhammad H
• Greco, Allison A
• Postelnicu, Radu
• Mukherjee, Vikramjit
• Horowitz, James
• Keller, Norma
• Bangalore, Sripal

Titel

Percutaneous mechanical thrombectomy in acute pulmonary embolism: Outcomes from a safety-net hospital

Ist Teil von

• Catheterization and cardiovascular interventions, 2024-05, Vol.103 (6), p.1042-1049

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2024

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Our study aims to present clinical outcomes of mechanical thrombectomy (MT) in a safety-net hospital. This is a retrospective study of intermediate or high-risk pulmonary embolism (PE) patients who underwent MT between October 2020 and May 2023. The primary outcome was 30-day mortality. Among 61 patients (mean age 57.6 years, 47% women, 57% Black) analyzed, 12 (19.7%) were classified as high-risk PE, and 49 (80.3%) were intermediate-risk PE. Of these patients, 62.3% had Medicaid or were uninsured, 50.8% lived in a high poverty zip code. The prevalence of normotensive shock in intermediate-risk PE patients was 62%. Immediate hemodynamic improvements included 7.4 mmHg mean drop in mean pulmonary artery pressure (-21.7%, p < 0.001) and 93% had normalization of their cardiac index postprocedure. Thirty-day mortality for the entire cohort was 5% (3 patients) and 0% when restricted to the intermediate-risk group. All 3 patients who died at 30 days presented with cardiac arrest. There were no differences in short-term mortality based on race, insurance type, citizenship status, or socioeconomic status. All-cause mortality at most recent follow up was 13.1% (mean follow up time of 13.4 ± 8.5 months). We extend the findings from prior studies that MT demonstrates a favorable safety profile with immediate improvement in hemodynamics and a low 30-day mortality in patients with acute PE, holding true even with relatively higher risk and more vulnerable population within a safety-net hospital.