Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience
Background Pulmonary embolism is an important cause of preventable mortality. Treatment strategies depend on risk stratification. High-risk patients, and some intermediate-high-risk patients, require urgent reperfusion therapy. Systemic thrombolysis (ST) is the effective first-choice treatment in th...
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| Veröffentlicht in: | Netherlands heart journal 2025-01, Vol.33 (1), p.14-25 |
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| creator | Hart, Einar A. Eenhoorn, Paul Nijkeuter, Mathilde Ruigrok, Dieuwertje van der Heijden, Joris J. Voskuil, Michiel Liu, Tommy K. K. Balder, Jan Willem van de Hoef, Tim P. van der Harst, Pim Kraaijeveld, Adriaan O. Dickinson, Michael G. |
| description | Background
Pulmonary embolism is an important cause of preventable mortality. Treatment strategies depend on risk stratification. High-risk patients, and some intermediate-high-risk patients, require urgent reperfusion therapy. Systemic thrombolysis (ST) is the effective first-choice treatment in these patients; however, the high risk of bleeding complications is a major drawback. In this single-centre retrospective cohort study, we report our experience with the FlowTriever thrombosuction system as an alternative or adjunct to ST in intermediate-high and high-risk pulmonary embolism.
Methods
Demographic and clinical data of all patients treated with the FlowTriever system from December 2021 until March 2024 were retrieved from the electronic medical records. Primary outcomes were technical success rate, 30-day all-cause mortality and major bleeding.
Results
Twenty-one patients were treated with the FlowTriever system, 14 of whom were considered high risk. The technical success rate was 100%. Thirty-day all-cause mortality was 29% and major bleeding was recorded in 5 patients (24%), of which one bleeding event was related to the FlowTriever procedure. A significant reduction was seen in mean pulmonary arterial pressure and right ventricular end-diastolic dimension.
Conclusion
In intermediate-high and high-risk pulmonary embolism patients with ST treatment failure or a contraindication for ST, the FlowTriever thrombosuction system seems to be a minimally invasive alternative treatment modality with low complication rates. |
| doi_str_mv | 10.1007/s12471-024-01916-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11695530</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3151019197</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-ce24f3f1f3c35b7f2770ded3d732071b030a3216492c765191ef0551e38d1f603</originalsourceid><addsrcrecordid>eNp9Uctu1TAQjRCIlsIPsECW2LAxeOzYTtig6ooCUiU2ZW35JpMbl8QOdtJyP4G_4Fv4MpzeUh4LVp7RnHPmjE9RPAX2EhjTrxLwUgNlvKQMalAU7hXHUGlFFZfsfq6lqqisquqoeJTSJWNSc9APiyNRK6mEVMfFt42de5wx0tZFbGZsSe6jnfbk2s392pCzIVxfRIdXGEnapxlH0oVInM-0EVtnZ6S92_XE-pasBY0ufSbTMozB27gnOG7D4NL4mtgf35PzuwFpg36OSPDrhFnaN_i4eNDZIeGT2_ek-HT29mLznp5_fPdhc3pOm2x4zjxedqKDTuR-qzuuNWuxFa0WnGnYMsGs4KDKmjdayfwv2DEpAUXVQqeYOCneHHSnZZvd3_iwg5miG7NXE6wzf0-8680uXBkAVUspVoUXtwoxfFkwzWZ0qcFhsB7DkoyAUilW16Az9Pk_0MuwRJ_vyygJa2z1iuIHVBNDShG7OzfAzBq1OURtctTmJmoDmfTszzvuKL-yzQBxAKQ88juMv3f_R_YntUC34g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3151019197</pqid></control><display><type>article</type><title>Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience</title><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Springer Nature OA Free Journals</source><creator>Hart, Einar A. ; Eenhoorn, Paul ; Nijkeuter, Mathilde ; Ruigrok, Dieuwertje ; van der Heijden, Joris J. ; Voskuil, Michiel ; Liu, Tommy K. K. ; Balder, Jan Willem ; van de Hoef, Tim P. ; van der Harst, Pim ; Kraaijeveld, Adriaan O. ; Dickinson, Michael G.</creator><creatorcontrib>Hart, Einar A. ; Eenhoorn, Paul ; Nijkeuter, Mathilde ; Ruigrok, Dieuwertje ; van der Heijden, Joris J. ; Voskuil, Michiel ; Liu, Tommy K. K. ; Balder, Jan Willem ; van de Hoef, Tim P. ; van der Harst, Pim ; Kraaijeveld, Adriaan O. ; Dickinson, Michael G.</creatorcontrib><description>Background
Pulmonary embolism is an important cause of preventable mortality. Treatment strategies depend on risk stratification. High-risk patients, and some intermediate-high-risk patients, require urgent reperfusion therapy. Systemic thrombolysis (ST) is the effective first-choice treatment in these patients; however, the high risk of bleeding complications is a major drawback. In this single-centre retrospective cohort study, we report our experience with the FlowTriever thrombosuction system as an alternative or adjunct to ST in intermediate-high and high-risk pulmonary embolism.
Methods
Demographic and clinical data of all patients treated with the FlowTriever system from December 2021 until March 2024 were retrieved from the electronic medical records. Primary outcomes were technical success rate, 30-day all-cause mortality and major bleeding.
Results
Twenty-one patients were treated with the FlowTriever system, 14 of whom were considered high risk. The technical success rate was 100%. Thirty-day all-cause mortality was 29% and major bleeding was recorded in 5 patients (24%), of which one bleeding event was related to the FlowTriever procedure. A significant reduction was seen in mean pulmonary arterial pressure and right ventricular end-diastolic dimension.
Conclusion
In intermediate-high and high-risk pulmonary embolism patients with ST treatment failure or a contraindication for ST, the FlowTriever thrombosuction system seems to be a minimally invasive alternative treatment modality with low complication rates.</description><identifier>ISSN: 1568-5888</identifier><identifier>EISSN: 1876-6250</identifier><identifier>DOI: 10.1007/s12471-024-01916-1</identifier><identifier>PMID: 39656356</identifier><language>eng</language><publisher>Houten: BSL Media & Learning</publisher><subject>Biomarkers ; Blood clots ; Cardiology ; Cardiovascular disease ; Catheters ; Contraindications ; Extracorporeal membrane oxygenation ; Hemodynamics ; Medical Education ; Medical imaging ; Medicine ; Medicine & Public Health ; Mortality ; Original ; Original Article ; Patients ; Pulmonary arteries ; Pulmonary embolisms ; Venous access</subject><ispartof>Netherlands heart journal, 2025-01, Vol.33 (1), p.14-25</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>Copyright Springer Nature B.V. Jan 2025</rights><rights>The Author(s) 2024 2024</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-ce24f3f1f3c35b7f2770ded3d732071b030a3216492c765191ef0551e38d1f603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695530/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695530/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41096,42165,51551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39656356$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hart, Einar A.</creatorcontrib><creatorcontrib>Eenhoorn, Paul</creatorcontrib><creatorcontrib>Nijkeuter, Mathilde</creatorcontrib><creatorcontrib>Ruigrok, Dieuwertje</creatorcontrib><creatorcontrib>van der Heijden, Joris J.</creatorcontrib><creatorcontrib>Voskuil, Michiel</creatorcontrib><creatorcontrib>Liu, Tommy K. K.</creatorcontrib><creatorcontrib>Balder, Jan Willem</creatorcontrib><creatorcontrib>van de Hoef, Tim P.</creatorcontrib><creatorcontrib>van der Harst, Pim</creatorcontrib><creatorcontrib>Kraaijeveld, Adriaan O.</creatorcontrib><creatorcontrib>Dickinson, Michael G.</creatorcontrib><title>Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience</title><title>Netherlands heart journal</title><addtitle>Neth Heart J</addtitle><addtitle>Neth Heart J</addtitle><description>Background
Pulmonary embolism is an important cause of preventable mortality. Treatment strategies depend on risk stratification. High-risk patients, and some intermediate-high-risk patients, require urgent reperfusion therapy. Systemic thrombolysis (ST) is the effective first-choice treatment in these patients; however, the high risk of bleeding complications is a major drawback. In this single-centre retrospective cohort study, we report our experience with the FlowTriever thrombosuction system as an alternative or adjunct to ST in intermediate-high and high-risk pulmonary embolism.
Methods
Demographic and clinical data of all patients treated with the FlowTriever system from December 2021 until March 2024 were retrieved from the electronic medical records. Primary outcomes were technical success rate, 30-day all-cause mortality and major bleeding.
Results
Twenty-one patients were treated with the FlowTriever system, 14 of whom were considered high risk. The technical success rate was 100%. Thirty-day all-cause mortality was 29% and major bleeding was recorded in 5 patients (24%), of which one bleeding event was related to the FlowTriever procedure. A significant reduction was seen in mean pulmonary arterial pressure and right ventricular end-diastolic dimension.
Conclusion
In intermediate-high and high-risk pulmonary embolism patients with ST treatment failure or a contraindication for ST, the FlowTriever thrombosuction system seems to be a minimally invasive alternative treatment modality with low complication rates.</description><subject>Biomarkers</subject><subject>Blood clots</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Catheters</subject><subject>Contraindications</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Hemodynamics</subject><subject>Medical Education</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pulmonary arteries</subject><subject>Pulmonary embolisms</subject><subject>Venous access</subject><issn>1568-5888</issn><issn>1876-6250</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp9Uctu1TAQjRCIlsIPsECW2LAxeOzYTtig6ooCUiU2ZW35JpMbl8QOdtJyP4G_4Fv4MpzeUh4LVp7RnHPmjE9RPAX2EhjTrxLwUgNlvKQMalAU7hXHUGlFFZfsfq6lqqisquqoeJTSJWNSc9APiyNRK6mEVMfFt42de5wx0tZFbGZsSe6jnfbk2s392pCzIVxfRIdXGEnapxlH0oVInM-0EVtnZ6S92_XE-pasBY0ufSbTMozB27gnOG7D4NL4mtgf35PzuwFpg36OSPDrhFnaN_i4eNDZIeGT2_ek-HT29mLznp5_fPdhc3pOm2x4zjxedqKDTuR-qzuuNWuxFa0WnGnYMsGs4KDKmjdayfwv2DEpAUXVQqeYOCneHHSnZZvd3_iwg5miG7NXE6wzf0-8680uXBkAVUspVoUXtwoxfFkwzWZ0qcFhsB7DkoyAUilW16Az9Pk_0MuwRJ_vyygJa2z1iuIHVBNDShG7OzfAzBq1OURtctTmJmoDmfTszzvuKL-yzQBxAKQ88juMv3f_R_YntUC34g</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Hart, Einar A.</creator><creator>Eenhoorn, Paul</creator><creator>Nijkeuter, Mathilde</creator><creator>Ruigrok, Dieuwertje</creator><creator>van der Heijden, Joris J.</creator><creator>Voskuil, Michiel</creator><creator>Liu, Tommy K. K.</creator><creator>Balder, Jan Willem</creator><creator>van de Hoef, Tim P.</creator><creator>van der Harst, Pim</creator><creator>Kraaijeveld, Adriaan O.</creator><creator>Dickinson, Michael G.</creator><general>BSL Media & Learning</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20250101</creationdate><title>Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience</title><author>Hart, Einar A. ; Eenhoorn, Paul ; Nijkeuter, Mathilde ; Ruigrok, Dieuwertje ; van der Heijden, Joris J. ; Voskuil, Michiel ; Liu, Tommy K. K. ; Balder, Jan Willem ; van de Hoef, Tim P. ; van der Harst, Pim ; Kraaijeveld, Adriaan O. ; Dickinson, Michael G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-ce24f3f1f3c35b7f2770ded3d732071b030a3216492c765191ef0551e38d1f603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Biomarkers</topic><topic>Blood clots</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Catheters</topic><topic>Contraindications</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Hemodynamics</topic><topic>Medical Education</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pulmonary arteries</topic><topic>Pulmonary embolisms</topic><topic>Venous access</topic><toplevel>online_resources</toplevel><creatorcontrib>Hart, Einar A.</creatorcontrib><creatorcontrib>Eenhoorn, Paul</creatorcontrib><creatorcontrib>Nijkeuter, Mathilde</creatorcontrib><creatorcontrib>Ruigrok, Dieuwertje</creatorcontrib><creatorcontrib>van der Heijden, Joris J.</creatorcontrib><creatorcontrib>Voskuil, Michiel</creatorcontrib><creatorcontrib>Liu, Tommy K. K.</creatorcontrib><creatorcontrib>Balder, Jan Willem</creatorcontrib><creatorcontrib>van de Hoef, Tim P.</creatorcontrib><creatorcontrib>van der Harst, Pim</creatorcontrib><creatorcontrib>Kraaijeveld, Adriaan O.</creatorcontrib><creatorcontrib>Dickinson, Michael G.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Netherlands heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hart, Einar A.</au><au>Eenhoorn, Paul</au><au>Nijkeuter, Mathilde</au><au>Ruigrok, Dieuwertje</au><au>van der Heijden, Joris J.</au><au>Voskuil, Michiel</au><au>Liu, Tommy K. K.</au><au>Balder, Jan Willem</au><au>van de Hoef, Tim P.</au><au>van der Harst, Pim</au><au>Kraaijeveld, Adriaan O.</au><au>Dickinson, Michael G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience</atitle><jtitle>Netherlands heart journal</jtitle><stitle>Neth Heart J</stitle><addtitle>Neth Heart J</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>33</volume><issue>1</issue><spage>14</spage><epage>25</epage><pages>14-25</pages><issn>1568-5888</issn><eissn>1876-6250</eissn><abstract>Background
Pulmonary embolism is an important cause of preventable mortality. Treatment strategies depend on risk stratification. High-risk patients, and some intermediate-high-risk patients, require urgent reperfusion therapy. Systemic thrombolysis (ST) is the effective first-choice treatment in these patients; however, the high risk of bleeding complications is a major drawback. In this single-centre retrospective cohort study, we report our experience with the FlowTriever thrombosuction system as an alternative or adjunct to ST in intermediate-high and high-risk pulmonary embolism.
Methods
Demographic and clinical data of all patients treated with the FlowTriever system from December 2021 until March 2024 were retrieved from the electronic medical records. Primary outcomes were technical success rate, 30-day all-cause mortality and major bleeding.
Results
Twenty-one patients were treated with the FlowTriever system, 14 of whom were considered high risk. The technical success rate was 100%. Thirty-day all-cause mortality was 29% and major bleeding was recorded in 5 patients (24%), of which one bleeding event was related to the FlowTriever procedure. A significant reduction was seen in mean pulmonary arterial pressure and right ventricular end-diastolic dimension.
Conclusion
In intermediate-high and high-risk pulmonary embolism patients with ST treatment failure or a contraindication for ST, the FlowTriever thrombosuction system seems to be a minimally invasive alternative treatment modality with low complication rates.</abstract><cop>Houten</cop><pub>BSL Media & Learning</pub><pmid>39656356</pmid><doi>10.1007/s12471-024-01916-1</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection; Springer Nature OA Free Journals |
| subjects | Biomarkers Blood clots Cardiology Cardiovascular disease Catheters Contraindications Extracorporeal membrane oxygenation Hemodynamics Medical Education Medical imaging Medicine Medicine & Public Health Mortality Original Original Article Patients Pulmonary arteries Pulmonary embolisms Venous access |
| title | Catheter-directed therapy with the FlowTriever system for intermediate-high and high-risk pulmonary embolism: a single-centre experience |
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