Mechanical thrombectomy for PE confers good 6-month clinical, quality of life outcomes
Click Here to Manage Email Alerts
Key takeaways:
- Large-bore mechanical thrombectomy for pulmonary embolism may be safe in the long term.
- Researchers observed improvement in echocardiographic parameters, exercise capacity and quality of life.
Pulmonary embolism treatment with a large-bore mechanical thrombectomy system was associated with favorable long-term outcomes, including low mortality and improved hemodynamics, functional capacity and quality of life, a speaker reported.
The 6-month results from an analysis of the FLASH registry, a prospective analysis of a mechanical thrombectomy system (FlowTriever, Inari Medical), were presented at the Society for Cardiovascular Angiography and Interventions Scientific Sessions.
Image: Adobe Stock
“Much of the focus in pulmonary embolism so far has been on the short-term outcomes: survival of the PE, markers such as right ventricle/left ventricle ratio. We know that patients after they survive their index pulmonary embolism are oftentimes left with significant long-term symptoms, like reductions in exercise capacity and reduced quality of life,” Sameer Khandhar, MD, assistant professor of clinical medicine at the Perelman School of Medicine at the University of Pennsylvania Penn Presbyterian Medical Center, said during a press conference. “The FlowTriever device is a form of large-bore mechanical thrombectomy, and its use has been shown to be effective and safe in the short term. The focus of this single-arm prospective registry study is to follow these patients out to 6 months and not only see the short-term benefits, but also the long-term benefits that this potentially may have.”
The FLASH registry included 800 patients with PE enrolled across 50 U.S. sites (mean age, 61 years; 54% men; 76.7% intermediate risk), all of whom underwent mechanical thrombectomy with a system designed to extracts PE thrombus via aspiration or mechanical modes without thrombolytics.
As Healio previously reported, among patients with intermediate- to high-risk PE, the mechanical thrombectomy system was found to be safe and was associated with good 48-hour hemodynamic and 30-day clinical outcomes.
For the present study, Khandhar and colleagues evaluated the 6-month outcomes among 599 patients who completed the study.
At 6 months, the rate of all-cause mortality was 4.6%, with no deaths or pulmonary or cardiac injuries associated with the mechanical thrombectomy system, according to the presentation.
Improvements in echocardiographic parameters including right ventricle/left ventricle ratio (baseline, 1.23; 30 days, 0.78; 6 months; 0.8; P < .0001) and the proportion of patients with normal right ventricular function (baseline, 15.1%; 30 days, 89.6%; 6 months, 95.1%; P < .0001) achieved at 30 days were sustained out to 6 months.
Moreover, improvement in patient-reported functional outcomes, including no or mild dyspnea (P compared with baseline < .0001), median 6-minute walk distance (P for trend < .001) and median Pulmonary Embolism Quality of Life (PEmb‐QoL) questionnaire score (P < .001) were achieved early and continued out to 6 months.
“In this study, the device was shown to be safe and effective, both in the short term as well as suggestive of significant improvements in RV function, patient symptoms, patient exercise capacity as well as in quality of life. We know that patients after pulmonary embolism can continue to have long-term symptoms and limitations,” Khandhar said during the press conference. “We feel that we owe it to the patients not only to focus on their survival of the pulmonary embolism, but also to focus on what we can do at the index hospitalization to help prevent long-term symptoms. We feel this study offers the building blocks for future studies that will need to take into account not only acute outcomes, but also long-term outcomes.”
Collapse
Khandhar S, et al. Late-Breaking Presentation V. Presented at: Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 18-20, 2023; Phoenix.
Click Here to Manage Email Alerts