Conical Mesh-Disc Catheter-Directed Mechanical Thrombectomy for Acute Pulmonary Embolism: A Nationwide Prospective, Multicenter, Single-Arm Study.
Hui Zhuang, Xiang Chen, Zeying Zhang et al.
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In 30 seconds
This nationwide prospective, multicenter, single-arm study assessed a conical mesh-disc catheter-directed mechanical thrombectomy system in adults with acute pulmonary embolism, right ventricular dilation, and stable blood pressure. Among 127 treated patients, device delivery, deployment, and removal succeeded in all cases. The CTPA-derived RV/LV ratio fell from 1.47 ± 0.37 at baseline to 0.83 ± 0.17 at 48 hours (95% CI: -0.69 to -0.59; P < 0.0001). No major adverse events occurred within 48 hours, and no deaths or symptomatic recurrent PE were reported within 30 days.
Key findings
- Device delivery, deployment, and removal were successful in all 127 patients.
- RV/LV ratio decreased from 1.47 ± 0.37 to 0.83 ± 0.17 at 48 hours (95% CI: -0.69 to -0.59; P < 0.0001).
- Echocardiography-estimated sPAP decreased from 45.82 ± 14.46 to 36.66 ± 13.18 mm Hg (mean change: -9.69 ± 14.33; P < 0.001).
- No major adverse events occurred within 48 hours; no deaths or symptomatic recurrent PE occurred within 30 days.
Why it matters
The study reports technical feasibility and early improvements in right ventricular size, estimated pulmonary artery pressure, and oxygenation after thrombectomy in hemodynamically stable patients with intermediate-risk acute PE and RV dilation. These findings add prospective multicenter evidence about this device, while the absence of a comparator means they do not establish whether thrombectomy improves outcomes over anticoagulation or other devices.
What to keep in mind
The single-arm design does not permit comparative effectiveness conclusions versus anticoagulation or other devices; reported safety follow-up was limited to 48 hours for major adverse events.