Key result
Mechanical thrombectomy for high-risk PE in pregnancy yields ~100% maternal survival despite frequent complications.
Why the study?
Pulmonary embolism in pregnancy poses major clinical challenges with limited evidence on mechanical thrombectomy as an alternative when thrombolysis is contraindicated.
Does mechanical thrombectomy improve maternal and fetal outcomes in pregnant women with high-risk pulmonary embolism?
Systematic Review (n=16)
Does mechanical thrombectomy improve maternal and fetal outcomes in pregnant women with high-risk pulmonary embolism?
Mechanical thrombectomy represents a viable and potentially life-saving therapeutic option for high-risk pulmonary embolism in pregnancy when systemic fibrinolysis is contraindicated, showing high maternal survival but a significant complication rate.
May support mechanical thrombectomy when fibrinolysis is contraindicated in pregnant patients with high-risk PE; extends limited evidence but requires prospective validation.
Pulmonary embolism (PE) in pregnancy is a major clinical challenge with potentially fatal maternal and fetal outcomes. Mechanical thrombectomy (MT) offers a promising alternative when thrombolysis is contraindicated, although evidence in pregnancy is limited. We describe a 26-year-old at 29 + 5 weeks’ gestation with high-risk PE causing acute right heart failure, successfully treated, achieving rapid hemodynamic recovery, and minimal fetal radiation exposure. A systematic review identified 15 MT cases in pregnancy or peripartum (11 antepartum, 4 postpartum), reporting 100% maternal survival and favorable fetal outcomes in 87% (1 fetal death, 1 abortion). Complications occurred in 40%, including hemolysis, renal failure, and hemorrhagic shock. MT appears to be an effective, potentially life-saving option in selected obstetric patients when performed in experienced centers with multidisciplinary support. Clinical Impact Mechanical thrombectomy (MT) represents a valuable therapeutic option for high-risk pulmonary embolism in pregnancy when thrombolysis is contraindicated. In this setting, MT allows for rapid reperfusion and hemodynamic stabilization while avoiding the bleeding risks associated with systemic fibrinolysis. Early consideration of MT within a multidisciplinary framework might significantly improve maternal prognosis without compromising fetal safety.
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Discalzi et al. (2026) conducted a systematic review in High-Risk Pulmonary Embolism in Pregnancy (n=16). Mechanical thrombectomy was evaluated on Maternal survival. Mechanical thrombectomy for high-risk pulmonary embolism in pregnancy resulted in 100% maternal survival and 87% favorable fetal outcomes, with complications occurring in 40% of cases.
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