Rheolytic thrombectomy with AngioJet System for treatment of acute pulmonary embolism(pe)
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1 Rheolytic thrombectomy with AngioJet System for treatment of acute pulmonary embolism(pe) Dr. Shuiting Zhai Vascular and Endovascular Surgery Henan Provincial People's Hospital Zhengzhou P.R.C
2 Disclosure Speaker name: Shuiting Zhai I have the following potential conflicts of interest to report: Consulting Employment in industry Stockholder of a healthcare company Owner of a healthcare company Other(s) I do not have any potential conflict of interest
3 The high in-hospital mortality of PE Stavros V. Konstantinides etc. Management of Pulmonary Embolism. JACC VOL. 67.NO
4 PE: An important healthy issue in China Pulmonary Embolism Extrapolated Incidence 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000, ,000 0 Hong Kong Japan China India France Germany USA Canada Belgium
5 Classification of acute pulmonary embolism Figure 1:ESC Guideline, European Heart Journal, 2014; Figure 2:Circulation 2011;16(123):
6 Treatment of Acute PE Guidelines of the American Venous Forum on the endovascular and surgical management of acute pulmonary embolism Jaff MR et al. Circulation 2011;123(16):
7 Percutaneous Catheter-Directed Treatment (i) Thrombus fragmentation with pigtail or balloon catheter (ii) Rheolytic thrombectomy with hydrodynamic catheter devices (iii) Suction thrombectomy with aspiration catheters (iv) Rotational thrombectomy ESC Guideline, European Heart Journal, 2014
8 AngioJet Rheolytic thrombectomy Reducing the risk of distal embolization; Less vessel damage; Thrombectomy device combination with thrombolysis; Be quite user-friendly; It can be operated safely and effectively. Am J Cardiol 2008;101: ; Interv. Cardiol. (2013) 5(1), 71 87
9 Single Center Experience A retrospective review to evaluate the safety, feasibility, and primary results of treatment for MPE or spe patients with ART; Total of 21 patients underwent ART (Jun and Dec ); 21 pts (9 M, 12 F ) with a mean age of 63.7 years (range: yrs); All ART procedures were conducted urgently, mean time from symptom onset to procedure: 19.8 ± 22.6 hours.
10 Single Center Experience
11 Single Center Experience
12 Single Center Experience
13 Single Center Experience
14 Single Center Experience Initial Results technical /procedural successes 21 (100%) Transient bradycardia(in %) 8 (38.1%) Transient asystole (in %) 1 (4.7%) Hemoptysis (in %) 3 (14.3%) Hematuria (in %) 6 (28.6%) Impairing of the renal function(in %) 2 (9.5%)
15 Single Center Experience Cumulative survival The mean follow-up time for the cohort was 10.5±6.8 months
16 CASE 1 CTPA and Pulmonary Angiography F, 55 yrs, High Risk PE
17 AngioJet Thrombectomy of PE
18 Post-operation DSA and CTPA Immediate 1 week
19 CASE 2 CTPA F, 66 yrs High Risk PE
20 AngioJet Thrombectomy of PE
21 AngioJet Thrombectomy of PE
22 Post-operation DSA and CTPA Immediate 1 week
23 Summary AngioJet device can be operated safely and effectively in most patients with MPE and smpe; Using AngioJet system with procedural modifications to avoid complications and improve clinical outcomes. There was no control group in our study, large randomized clinical trials are needed to assess the risk-benefit ratio of ART.
24 Thanks for your attention!
25 Rheolytic thrombectomy with AngioJet System for treatment of acute pulmonary embolism(pe) Dr. Shuiting Zhai Vascular and Endovascular Surgery Henan Provincial People's Hospital Zhengzhou P.R.C
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