Mechanical Thrombectomy for Pulmonary Embolism

Mechanical thrombectomy for pulmonary embolism is a minimally invasive catheter-based procedure used to physically remove blood clots from the pulmonary arteries. Pulmonary embolism occurs when a blood clot, commonly originating from the deep veins of the legs or pelvis, travels to the lungs and obstructs pulmonary blood flow. Depending on the severity of PE, patients may develop shortness of breath, chest pain, rapid heartbeat, low oxygen levels, dizziness, fainting or cardiovascular instability. A pulmonary embolism can also place significant strain on the right side of the heart. Anticoagulant medication is the primary treatment for many patients with acute pulmonary embolism. However, selected patients with higher-risk PE or clinical deterioration may require advanced treatment such as mechanical thrombectomy, catheter-directed thrombolysis or surgical embolectomy. Mechanical thrombectomy uses a specialised catheter-based system to remove or aspirate the blood clot from the pulmonary arteries. The procedure is performed through venous access, commonly through the femoral vein, and the catheter is guided toward the pulmonary arteries using imaging. Before treatment, the medical team evaluates haemodynamic stability, right ventricular function, oxygenation, clot characteristics, bleeding risk and other medical conditions. Mechanical thrombectomy may be considered for selected patients with significant pulmonary embolism, right ventricular strain, clinical deterioration or situations where thrombolytic treatment may not be suitable. It is not routinely required for every patient with pulmonary embolism. During the procedure, a specialised catheter is advanced to the pulmonary arteries containing the clot. The thrombectomy device is then used to remove or aspirate the thrombus. After clot removal, pulmonary blood flow, right ventricular function, oxygenation and the patient's overall clinical response are assessed. Recovery depends on the severity of the pulmonary embolism and the patient's overall health. After the procedure, the patient is monitored for heart rhythm, blood pressure, oxygen levels, bleeding, vascular access complications and recurrent symptoms. Anticoagulation is generally continued according to the patient's individual treatment plan. Follow-up may be required to evaluate recovery, persistent breathlessness, exercise limitation or other symptoms following pulmonary embolism. The appropriate treatment for pulmonary embolism is determined individually. Depending on the clinical situation, treatment may include anticoagulation, thrombolysis, catheter-based mechanical thrombectomy or surgical treatment.