Percutaneous Thrombectomy With Flowtriever System in Pregnant Women With High-Risk Pulmonary Embolism and Contraindications to Systemic Thrombolysis

Abstract

High-risk pulmonary embolism (PE) is a serious and potentially fatal condition in pregnant and postpartum women. Clinical practice guidelines recommend managing high-risk PE in the general population with systemic thrombolysis as the first therapeutic option. However, pregnant and especially early postpartum women may have a high risk of bleeding that contraindicates this therapy. In this regard, dedicated percutaneous large-bore aspiration catheters may be a promising alternative for this population. We present 2 cases of pregnant women diagnosed with high-risk PE and an absolute contraindication to systemic thrombolysis, successfully treated with percutaneous mechanical thrombectomy using a dedicated large-bore aspiration catheter. There were no complications, and both patients were discharged with full recovery and subsequently had uncomplicated deliveries. Clinical Impact Through these clinical cases, we present a new protocol of action, updated with the latest evidence on percutaneous pulmonary thrombectomy using dedicated catheters, for high-risk PE in pregnant women or during the early postpartum period.