Endovascular treatment of pulmonary embolism: Selective review of available techniques

Table 1 Comparison of pulmonary embolism treatment devices based on currently available evidence

Treatment method	Type of device	No. of patients	Outcomes
Suction thrombectomy	Greenfield suction embolectomy catheter	n = 46[32] 33 with massive PE 4 with submassive PE 9 with chronic PE	Mean PAP reduction from 32 to 24 mmHg in 31 patients
	Angiovac	n = 5[34] 4 with massive PE 1 with submassive PE	Technical success in 2 of the 4 patients with massive PE
	Flowtriever	n = 1[35]	Procedure successful
	Flowtriever	FLARE trial - ongoing	pending
	Penumbra	None	None
Mechanical thrombectomy	Amplatz thrombectomy device	n = 9[36] (5 were treated with tPA)	Reduction of Miller index from 18 to 11 Mean PAP reduction from 57 to 55 mmHg Addition of tPA achieved further mean PAP reduction to 39 mmHg
	Angiojet	n = 15[37] 10 were treated with tPA	9 patients - significant clot resolution 5 patients - moderate clot resolution 1 patient - minimal clot resolution
	Angiojet	n = 51[38] 22 patients - massive PE 29 patients - submassive PE	92% technical success Mean reduction of Miller index by 51%
Catheter directed fibrinolysis	USAT	n = 59[47] (ULTIMA trial) 29 patients - UFH alone 30 patients - unfractionated heparin + USAT	Greater mean decrease of RV/LV ratio in the UFH + USAT group vs UFH alone (0.30 vs 0.03)

PE: Pulmonary embolism; USAT: Ultrasound-assisted thrombolysis; PAP: Pulmonary arterial pressure; RV/LV: Right ventricle to left ventricle ratio; UFH: Unfractionated heparin.