University of Iowa physicians are the first in the state to use a novel device to remove life-threatening blood clots from the lungs of a critically ill patient.
The patient had a massive pulmonary embolism—large blood clots obstructing both lung arteries and causing shock.
The patient was assessed by the UI Pulmonary Embolus Response Team (PERT), a multidisciplinary group of cardiac surgeons, cardiologists, critical care physicians, interventional radiologists, and vascular surgeons. PERT physicians rapidly evaluate patients with this condition and recommend the best treatment options.
In this case, the patient was deemed to be too ill for many treatments and required immediate life-saving support with extracorporeal membrane oxygenation (ECMO), which uses a pump to circulate blood through an artificial lung back into the bloodstream. The University of Iowa has the state’s only comprehensive ECMO center.
Arun Singhal, MD, UI associate professor of surgery–cardiothoracic surgery, emergently placed the patient on ECMO support to stabilize blood pressure and lung function.
The team then recommended an attempt at removing the clots with the novel catheter device. James D. Rossen, MD, UI professor of internal medicine–interventional cardiology, and Singhal took the lead on the first-in-Iowa procedure.
They used the FlowTriever (Inari Medical) thrombectomy system, a single-use, catheter-based mechanical thrombectomy device approved by the U.S. Food and Drug Administration. The device is advanced from the femoral vein to the pulmonary artery bloods clots, which are removed by suction and a catheter that engages the clots with self-expanding metal mesh disks.
The patient immediately improved after thrombectomy and was taken off ECMO the following day and discharged home seven days later.
“Mechanical thrombectomy is an important treatment option for patients with large pulmonary emboli causing shock or respiratory failure,” Rossen says. “Our advanced expertise and multidisciplinary approach gives us the ability to provide this kind of state-of-the-art treatment sooner, so we can offer our patients the best available care.”
The FlowTriever retrieval/aspiration system is the latest addition to the range of patient-tailored options offered by the UI PERT. The service also offers advanced medication therapies, surgical clot removal, and catheter-based clot removal in addition to more standard treatment options.