Percutaneous mechanical thrombectomy in acute pulmonary embolism: Outcomes from a safety‐net hospital

Abstract

AbstractBackgroundOur study aims to present clinical outcomes of mechanical thrombectomy (MT) in a safety‐net hospital.MethodsThis is a retrospective study of intermediate or high‐risk pulmonary embolism (PE) patients who underwent MT between October 2020 and May 2023. The primary outcome was 30‐day mortality.ResultsAmong 61 patients (mean age 57.6 years, 47% women, 57% Black) analyzed, 12 (19.7%) were classified as high‐risk PE, and 49 (80.3%) were intermediate‐risk PE. Of these patients, 62.3% had Medicaid or were uninsured, 50.8% lived in a high poverty zip code. The prevalence of normotensive shock in intermediate‐risk PE patients was 62%. Immediate hemodynamic improvements included 7.4 mmHg mean drop in mean pulmonary artery pressure (−21.7%, p < 0.001) and 93% had normalization of their cardiac index postprocedure. Thirty‐day mortality for the entire cohort was 5% (3 patients) and 0% when restricted to the intermediate‐risk group. All 3 patients who died at 30 days presented with cardiac arrest. There were no differences in short‐term mortality based on race, insurance type, citizenship status, or socioeconomic status. All‐cause mortality at most recent follow up was 13.1% (mean follow up time of 13.4 ± 8.5 months).ConclusionWe extend the findings from prior studies that MT demonstrates a favorable safety profile with immediate improvement in hemodynamics and a low 30‐day mortality in patients with acute PE, holding true even with relatively higher risk and more vulnerable population within a safety‐net hospital.