Key result
Rheolytic thrombectomy with a cerebral embolic protection device was successfully used to treat life-threatening pulmonary embolism in a fenestrated Fontan patient.
Why the study?
Clinical thromboembolism in Fontan patients often results in death and adverse long-term outcomes, and the treatment of acute thromboembolic complications in these patients remains very controversial.
Does percutaneous rheolytic thrombectomy with cerebral embolic protection safely treat massive thrombosis in a fenestrated Fontan conduit?
Case Report (n=1)
Does percutaneous rheolytic thrombectomy with cerebral embolic protection safely treat massive thrombosis in a fenestrated Fontan conduit?
Percutaneous rheolytic thrombectomy combined with cerebral embolic protection offers a potentially safe and effective alternative to surgery or systemic thrombolysis for massive thrombosis in fenestrated Fontan patients.
May be feasible for acute PE in Fontan patients; leaves open need for prospective validation before wider use.
Background: Clinical thromboembolism in Fontan patients is often a catastrophic event resulting in death and adverse long-term outcomes. The treatment of acute thromboembolic complications in these patients is very controversial. Case summary: We describe the use of rheolytic thrombectomy in a Fontan patient with life-threatening pulmonary embolism, employing a cerebral protection system to reduce the risk of stroke through the fenestration. Discussion: Rheolytic thrombectomy may be a successful alternative to systemic thrombolytic therapy and open surgical resection for the treatment of acute high-risk pulmonary embolism in the Fontan population. Embolic protection device to capture and remove thrombus/debris may be an innovative tool to reduce the risk of stroke through the fenestration while performing a percutaneous procedure in fenestrated Fontan patient.
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Marzullo et al. (2023) conducted a case report in Massive thrombosis of a fenestrated Fontan conduit with life-threatening pulmonary embolism (n=1). Rheolytic thrombectomy and cerebral embolic protection was evaluated. Rheolytic thrombectomy with a cerebral embolic protection device was successfully used to treat life-threatening pulmonary embolism in a fenestrated Fontan patient.
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