The use of mechanical thrombectomy (MT) was associated with reduced major adverse events in the short term and improved quality of life in the long-term for pulmonary embolism patients with pulmonary hypertension, according to US research.

 

The impact of MT on adverse events and long-term outcomes in pulmonary embolism patients with severe pulmonary hypertension has not been well studied, wrote Kenneth Cho of Jefferson Einstein Montgomery Hospital, Pennsylvania.

 

In a study presented at the annual meeting of the Society for Interventional Radiology, the researchers reviewed 6-month outcome data after the use of MT in pulmonary embolism patients with severe pulmonary hypertension. Data were taken from a prospective, multicenter registry (the FLASH registry) created to evaluate the safety and effectiveness of the FlowTriever System for medical thrombectomy in patients with severe pulmonary hypertension, defined as systolic pulmonary artery pressure of at least 70 mmHg.

 

The primary study endpoint was a composite score of major adverse events within 48 hours of treatment; patients were then followed for 6 months. A total of 83 patients completed the full study with a mean of approximately 204 days of follow-up. Most of the patients (92.9%) were considered intermediate-risk for pulmonary embolism, and 7.1% were high-risk.

 

Within 48 hours of MT, average systolic pulmonary artery pressure decreased significantly, from 78.9 mmHg to 60.9 mmHg (P < .0001). In addition, 74.2% of patients experienced resolution or reduced severity of pulmonary hypertension. The rate of major adverse events was 3.1% within the first 48 hours.

 

Over the long-term follow-up, patients reported improvements in right ventricular/left ventricular ratio (RV/LV), RV systolic pressure, and RV function, which indicated lasting resolution of PH, the researchers noted.

 

At 6 months, patients also reported reductions in dyspnea and improvements in quality of life and experienced lower rates of all-cause mortality, chronic thromboembolic pulmonary hypertension, and chronic thromboembolic pulmonary vascular disease, the researchers wrote in their abstract.