What is the clinical evidence from this study?

Study design: Case Report. Population: Massive pulmonary embolism (n=1). Intervention: Catheter-directed mechanical thrombectomy. Primary outcome: Clinical and cardiac imaging improvement.

What does this research mean for the field?

Rescue catheter-directed mechanical thrombectomy is an effective and safe treatment option for achieving significant thrombus removal and clinical improvement in patients with massive pulmonary embolism following failed systemic thrombolysis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the feasibility, safety, and clinical efficacy of catheter-directed mechanical thrombectomy as a rescue therapy following failed systemic thrombolysis in massive pulmonary embolism.

September 15, 2026European Heart Journal Supplements

Mechanical Thrombectomy After Failed Thrombolysis in Massive Pulmonary Embolism: A Case Report

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Key result

Rescue catheter-directed mechanical thrombectomy achieves rapid clinical improvement in massive PE after failed systemic thrombolysis.

Key Points

To describe the feasibility, safety, and clinical efficacy of catheter-directed mechanical thrombectomy as a rescue therapy following failed systemic thrombolysis in massive pulmonary embolism.
A 63-year-old woman presenting with massive saddle pulmonary embolism, hypotension, and right ventricular dysfunction was initially treated with systemic alteplase followed by intravenous heparin.
Due to persistent respiratory distress, right ventricular strain, and confirmed pulmonary infarction, rescue catheter-directed mechanical aspiration was conducted using a 20 Fr Inari FlowTriever system with blood reinfusion.
Mechanical aspiration passes achieved significant bilateral thrombus extraction and rapid improvement in pulmonary artery pressures.
The patient exhibited rapid hemodynamic recovery, resolution of right ventricular dysfunction on echocardiography, and was successfully discharged on oral edoxaban.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 63-year-old woman with massive pulmonary embolism who underwent rescue catheter-directed mechanical thrombectomy after failed systemic thrombolysis.

Intervention

Rescue catheter-directed mechanical thrombectomy using a 20 Fr Inari FlowTriever system with blood reinfusion via the FlowSaver system.

Outcome

Clinical and hemodynamic improvement (improvement in pulmonary pressures, rapid improvement in clinical conditions and cardiac imaging data).

Catheter-directed mechanical thrombectomy represents an effective and safe rescue option for massive pulmonary embolism after failed systemic thrombolysis.

Discussion

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Implication

May support rescue thrombectomy after failed thrombolysis in massive PE; leaves open need for prospective trials.

Cite This Study

Miletti et al. (2026) conducted a case report in Massive pulmonary embolism (n=1). Catheter-directed mechanical thrombectomy was evaluated on Clinical and cardiac imaging improvement. Rescue catheter-directed mechanical thrombectomy achieved significant thrombus removal and rapid clinical improvement in a patient with massive pulmonary embolism after failed systemic thrombolysis.

synapsesocial.com/papers/6aa9017deed42882c1fc197c https://doi.org/10.1093/eurheartjsupp/suag058.382

Topics

Atrial fibrillation Persistent AF management Pulmonary embolism

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Mechanical Thrombectomy After Failed Thrombolysis in Massive Pulmonary Embolism: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Mechanical Thrombectomy After Failed Thrombolysis in Massive Pulmonary Embolism: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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