Catheter-Based Interventions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Synonyms and keywords: PE
Overview
Catheter based intervention is a means of opening blocked arteries. These includes percutaneous intervention for removing pulmonary emboli and decreasing thrombus burden. Following three methods are adopted:
- Aspiration thrombectomy:uses sustained suction force to secure and remove the thrombus.
- Rheolytic thrombectomy:use a saline jet (high-velocity) to fragment thrombus. It creates a Venturi effect and removes the debris into an evacuation lumen
- Thrombus fragmentation
Indications
Transcatheter procedures can be performed as an alternative to thrombolysis when
- Thrombolysis is contraindications
- When emergency surgical thrombectomy is unavailable or contraindicated.
- when thrombolysis has failed to improve hemodynamics in the acute setting.
Therapeutic Goal
The goals of catheter-based therapy include
- Rapidly reducing pulmonary artery pressure, RV strain, and pulmonary vascular resistance (PVR)
- Increasing systemic perfusion
- Facilitating RV recovery.