Clinical Outcomes following Mechanical Thrombectomy in Pulmonary Embolism Response Team-Consulted Patients: A Retrospective Analysis.

IF 2.6 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Ryan Nolan, Maanasi Samant, Suresh Vedantham, Westley Ohman, Nathan Droz, Kristen Sanfilippo, Pavan Kavali
{"title":"Clinical Outcomes following Mechanical Thrombectomy in Pulmonary Embolism Response Team-Consulted Patients: A Retrospective Analysis.","authors":"Ryan Nolan, Maanasi Samant, Suresh Vedantham, Westley Ohman, Nathan Droz, Kristen Sanfilippo, Pavan Kavali","doi":"10.1016/j.jvir.2025.09.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high-risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).</p><p><strong>Methods: </strong>This retrospective, single-center study included patients with intermediate-high-risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics.</p><p><strong>Results: </strong>Of 335 patients, 259 received AC alone and 76 received MT + AC. The use of MT was associated with reduced odds of 30-day all-cause mortality (odds ratio, 0.49; 95% CI, 0.27-0.76; P = .002). There were no significant differences in PE-associated/caused mortality. Hospital LOS was 2 days shorter in the MT + AC cohort (P < .001). Of patients receiving MT + AC, those with high-risk PE had a 4.5-day shorter stay (P < .001), whereas those with intermediate-high-risk PE had a 2-day shorter stay (P < .001). The proportion of patients receiving supplemental oxygen at discharge was lower in the MT + AC group (MT + AC vs AC, 4.1% vs 18.5%; P < .001), without significant differences in 30-day readmission rates (MT + AC vs AC, 9.5% vs 20.6%; P = .115). MT resulted in an 8.7-mm Hg reduction in mean pulmonary artery pressure, had a technical success rate of 100% (76 of 76), and an adverse event rate of 6.6% (5 of 76).</p><p><strong>Conclusions: </strong>MT reduced 30-day all-cause mortality, hospital LOS, and supplemental oxygen at discharge in the intermediate-high-risk and high-risk PE population.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvir.2025.09.008","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high-risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).

Methods: This retrospective, single-center study included patients with intermediate-high-risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics.

Results: Of 335 patients, 259 received AC alone and 76 received MT + AC. The use of MT was associated with reduced odds of 30-day all-cause mortality (odds ratio, 0.49; 95% CI, 0.27-0.76; P = .002). There were no significant differences in PE-associated/caused mortality. Hospital LOS was 2 days shorter in the MT + AC cohort (P < .001). Of patients receiving MT + AC, those with high-risk PE had a 4.5-day shorter stay (P < .001), whereas those with intermediate-high-risk PE had a 2-day shorter stay (P < .001). The proportion of patients receiving supplemental oxygen at discharge was lower in the MT + AC group (MT + AC vs AC, 4.1% vs 18.5%; P < .001), without significant differences in 30-day readmission rates (MT + AC vs AC, 9.5% vs 20.6%; P = .115). MT resulted in an 8.7-mm Hg reduction in mean pulmonary artery pressure, had a technical success rate of 100% (76 of 76), and an adverse event rate of 6.6% (5 of 76).

Conclusions: MT reduced 30-day all-cause mortality, hospital LOS, and supplemental oxygen at discharge in the intermediate-high-risk and high-risk PE population.

肺栓塞反应小组咨询患者机械取栓后的临床结果:回顾性分析。
目的:该研究旨在确定机械取栓(MT)的使用是否会影响急性中、高、高风险肺栓塞(PE)患者的生存和其他结果,PE反应小组(PERT)对这些患者进行了评估。方法:这项回顾性、单中心研究纳入了接受PERT评估超过3.5年的中高、高危PE患者,这些患者接受抗凝治疗(AC)或MT+抗凝治疗(MT+AC)。主要终点是30天全因死亡率,用治疗加权的逆概率测量。探索性结果包括研究期间的生存率、pe相关/引起的死亡率、住院时间(LOS)、出院时补充氧气和mt相关指标。结果:335例患者中,259例单独接受AC治疗,76例接受MT+AC治疗。MT的使用与30天全因死亡率降低相关(OR=0.49, 95%CI=0.27-0.76, p=0.002)。pe相关/引起的死亡率没有显著差异。在MT+AC队列中,医院LOS缩短了2天(p结论:MT降低了30天的全因死亡率、医院LOS和中高风险PE人群出院时的补充氧)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.30
自引率
10.30%
发文量
942
审稿时长
90 days
期刊介绍: JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信