3:27 PM Abstract No. 258 Outcomes of mechanical thrombectomy using the Inari FlowTriever system for the treatment of acute pulmonary embolism

Abstract

To evaluate the outcomes of patients who underwent mechanical thrombectomy using the Inari FlowTriever System for acute pulmonary embolism. Multiple studies have shown mechanical thrombectomy to be safe and effective in treating patients with intermediate-risk PE (evidence of right heart strain without hemodynamic compromise) and, more recently, high-risk PE over a short-term follow-up period. This single-center study evaluates the outcomes of mechanical thrombectomy in treating intermediate-risk and high-risk PE in a diverse patient population. All patients who underwent mechanical thrombectomy using the Inari FlowTriever System between June 2018 and September 2019 for the treatment of acute pulmonary embolism were identified. We report technical success, procedural complications, and short- and long-term outcomes. During the study period, 23 patients underwent 25 interventions for acute PE (14 submassive, 11 massive.) Of the submassive cohort, 5 were classified as low-intermediate risk and 9 as high-intermediate risk. Mean patient age was 57 years (range, 17-85.) 39% (9/23) had a history of cancer or active cancer. 79% (15/19) were found to have concurrent deep vein thrombosis. 26% (6/23) had a contraindication to systemic thrombolysis. Mechanical thrombectomy was successful in 84% (21/25) of the interventions. In successful cases, the average fluoroscopy time was 22.0 minutes. 78% (18/23) of patients survived to hospital discharge. There were three major adverse events; all intraprocedural mortalities related to cardiopulmonary collapse rather than device-related complication. Two additional patients did not survive to hospital discharge. Both had complications related to stroke, the first occurring prior to thrombectomy and the second following thrombectomy. Despite a reasonable rate of technical success, optimal patient selection strategies and long-term benefits of mechanical thrombectomy for the treatment of acute pulmonary embolism have yet to be elucidated.