AngioJet™

Ultra Thrombectomy System

Case Study:

Pulmonary Embolism

Thrombectomy of High Risk Pulmonary Embolism

Patient with active GI bleeding precluding the use of lytic. Main pulmonary artery angiography (more selective to the right) performed with an angulated 6-Fr pigtail catheter, showing the presence of a large thrombus within the right and left pulmonary arteries and respective lobar branches.

 

Rheolytic thrombectomy performed with AngioJet® PE catheter through a 0.035’’ hydrophilic guide wire, starting in the left pulmonary artery and inferior lobar branch. Procedure was repeated in the right pulmonary artery and corresponding lobar branches. Procedure was terminated because of bradyarrhythmia. Furthermore, total activation time was near the  recommended limit (4 minutes).
Despite large volume of thrombus removed, final angiogram shows only a mild improvement of obstruction. However, the treatment goal is to simply restore flow and not remove all thrombus since even this modest angiographic result was accompanied with significant hemodynamic and gas exchange recovery.
Rita Faria - Gaia Hospital Center, Cardiology Department, Vila Nova de Gaia, Portugal.

Thrombectomy of Left Pulmonary Artery

Left pulmonary angiography performed with an angulated 6-Fr pigtail catheter, demonstrating the presence of a large thrombus within the left pulmonary artery and the middle and lower lobar branches.
Rheolytic thrombectomy performed with the AngioJet® PE catheter through an 8-Fr multipurpose guiding catheter over a 0.035’’ hydrophylic guide wire.
Left pulmonary angiography performed after rheolytic thrombectomy showing the improvement of the obstruction and perfusion index.
Left pulmonary angiography performed with an angulated 6-Fr pigtail catheter, demonstrating the presence of thrombus within the left pulmonary artery and the upper, middle and lower lobar branches.
Rheolytic thrombectomy performed with the AngioJet® PE catheter through an 8-Fr multipurpose guiding catheter and a 0.035’’ hydrophylic guide wire.
Left pulmonary angiography performed after rheolytic thrombectomy showing the improvement of the obstruction and perfusion index.

Massimo Margheri, Vecchio Sabine, Cardiology Department, Ravenna, Italy

Thrombectomy of Right Pulmonary Artery

Right pulmonary angiography performed with an angulated 6-Fr pigtail catheter, demonstrating the presence of a large thrombus within the right pulmonary artery and the upper, middle and lower lobar branches.
Rheolytic thrombectomy performed with the AngioJet® PE catheter through an 8-Fr multipurpose guiding catheter and a 0.035’’ hydrophylic guide wire, in the middle and lower lobar branches.
Right pulmonary angiography performed after rheolytic thrombectomy showing the improvement of the obstruction and perfusion indexes.
Right pulmonary angiography performed with an angulated 6-Fr pigtail catheter, demonstrating the presence of thrombus within the right pulmonary artery and lower lobar branches.
Rheolytic thrombectomy performed with the AngioJet® PE catheter through an 8-Fr multipurpose guiding catheter and a 0.035’’ hydrophylic guide wire.
Right pulmonary angiography performed after rheolytic thrombectomy showing the improvement of the obstruction and perfusion indexes.
Massimo Margheri, Vecchio Sabine, Cardiology Department, Ravenna, Italy
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