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
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
The high in-hospital mortality of PE Stavros V. Konstantinides etc. Management of Pulmonary Embolism. JACC VOL. 67.NO. 8. 2016
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 1,000,000 500,000 0 Hong Kong Japan China India France Germany USA Canada Belgium http://www.wrongdiagnosis.com/p/pulmonary_embolism/stats-country.htm
Classification of acute pulmonary embolism Figure 1:ESC Guideline, European Heart Journal, 2014; Figure 2:Circulation 2011;16(123):1788 830.
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):1788 830
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
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;101:252 258; Interv. Cardiol. (2013) 5(1), 71 87
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. 2016 and Dec. 2017 ); 21 pts (9 M, 12 F ) with a mean age of 63.7 years (range: 48-72 yrs); All ART procedures were conducted urgently, mean time from symptom onset to procedure: 19.8 ± 22.6 hours.
Single Center Experience
Single Center Experience
Single Center Experience
Single Center Experience
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%)
Single Center Experience Cumulative survival The mean follow-up time for the cohort was 10.5±6.8 months
CASE 1 CTPA and Pulmonary Angiography F, 55 yrs, High Risk PE
AngioJet Thrombectomy of PE
Post-operation DSA and CTPA Immediate 1 week
CASE 2 CTPA F, 66 yrs High Risk PE
AngioJet Thrombectomy of PE
AngioJet Thrombectomy of PE
Post-operation DSA and CTPA Immediate 1 week
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.
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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