A Novel Case of Cardiac Tamponade after Percutaneous Pulmonary Embolectomy Using the FlowTriever Retrieval/Aspiration System
  • Mian Tanveer Ud Din
    Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
  • Deeksha Ramanujam
    Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
  • Adeel Nasrullah
    Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, PA, USA
  • Obaid Ashraf
    Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, PA, USA
  • Varun Chalasani
    Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
  • Tiffany Dumont
    Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, PA, USA

Keywords

Cardiac tamponade, percutaneous pulmonary embolectomy, FlowTriever retrieval/aspiration system, micro-perforation

Abstract

Introduction: Percutaneous embolectomy using the percutaneous large-bore aspiration embolectomy FlowTriever system (INARI Medical, Irvine, CA, USA) is a promising method for reducing high clot burden in patients with intermediate- to high-risk pulmonary embolism (PE).

Case Description: A 45-year-old woman with intermediate- to high-risk PE underwent percutaneous intervention using the FlowTriever retrieval/aspiration system. After the procedure, she experienced several cardiac arrests from pericardial tamponade and required pericardiocentesis, leading to haemodynamic stabilization.

Discussion: To our knowledge, this is the first documented case of the use of the FlowTriever system causing micro-perforation of the right ventricle, resulting in tamponade and cardiac arrest.

Conclusion: Percutaneous embolectomy has shown promise results in reducing clot burden and improving haemodynamic stability but has risks and limitations and requires specialized knowledge and training. In addition, more data are required from centres using the FlowTriever system to ensure adequate training and safety.

VIEW THE ENTIRE ARTICLE

References

  • Maturana MA, Seitz MP, Pour-Ghaz I, Ibebuogu UN, Khouzam RN. Invasive strategies for the treatment of pulmonary embolism. Where are we in 2020? Curr Probl Cardiol 2021;46(3):100650.
  • Tu T, Toma C, Tapson VF, Adams C, Jaber WA, Silver M, et al. A prospective, single-arm, multicenter trial of catheter-directed mechanical thrombectomy for intermediate-risk acute pulmonary embolism. JACC Cardiovasc Interv 2019;12(9):859–869.
  • Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al.; Task Force for the diagnosis and management of acute pulmonary embolism of the european society of cardiology (ESC). 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014;35(43):3033–3080.
  • Anderson FA, Zayaruzny M, Heit JA, Fidan D, Cohen AT. Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism. Am J Hematol 2007;82(9):777–782.
  • Bishay VL, Adenikinju O, Todd R. FlowTriever Retrieval System for the treatment of pulmonary embolism: overview of its safety and efficacy. Expert Rev Med Devices 2021;18(11):1039–1048.
  • Weinberg AS, Dohad S, Ramzy D, Madyoon H, Tapson VF. Clot extraction with the FlowTriever device in acute massive pulmonary embolism.J Intensive Care Med 2016;31(10):676–679.
  • Todoran TM, Sobieszczyk P. Catheter-based therapies for massive pulmonary embolism. Prog Cardiovasc Dis 2010;52(5):429–437.
  • Skaf E, Beemath A, Siddiqui T, Janjua M, Patel NR, Stein PD. Catheter-tip embolectomy in the management of acute massive pulmonary embolism. Am J Cardiol 2007;99(3):415–420.
  • Sobieszczyk P. Catheter-assisted pulmonary embolectomy.Circulation 2012;126(15):1917–1922.
  • Views: 430
    HTML downloads: 215
    PDF downloads: 251


    Published: 2022-08-26
    Issue: 2022: Vol 9 No 8 (view)


    How to cite:
    1.
    Tanveer Ud Din M, Ramanujam D, Nasrullah A, Ashraf O, Chalasani V, Dumont T. A Novel Case of Cardiac Tamponade after Percutaneous Pulmonary Embolectomy Using the FlowTriever Retrieval/Aspiration System. EJCRIM 2022;9 doi:10.12890/2022_003522.