Percutaneous rheolytic thrombectomy in the treatment of high-risk acute pulmonary embolism: Initial experience of a single center

For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strategies: thrombolysis, whose benefits have been documented in randomized trials, and surgical embolectomy. However, mechanical reperfusion by percutaneous techniques is used in an increasing number of patients, and is a valid therapeutic option when there is a formal contraindication to thrombolysis, as rescue therapy when thrombolysis fails to improve hemodynamics, and/or when emergency surgical thrombectomy is unavailable or contraindicated. This article discusses the indications for the use of percutaneous techniques in PE, reports the initial experience of our center with the AngioJet (R) thrombectomy device (Possis Medical Inc, Minneapolis, MN, USA) and reviews the available evidence, the most recent recommendations and the main complications associated with this procedure. (C) 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.