Pulmonary Embolism. Mechanical Thrombectomy

Treatment options for massive and sub-massive PE including mechanical thrombectomy devices.

[@shadowcreekranch]

Thank you Professor for this lecture. Really appreciate your sharing the technique with the angled pigtail - would you happen to have any fluoroscopic images showing the technique? Have not seen this described before in the literature so would be interested if you had any references. Thanks so much.

[@whiteboardandmarkercardiol2787]

No reference that I know of. Its just small tricks that you learn while troubleshooting in complicated patients with dilated RA/RV or severe pulmonary HTN. You can put a swan or 0.035 wire and over that a pigtail. Counter clock the Catheter to point toward 2’o clock and cross the tricuspid valve. Now clock the catheter to point toward 11’o clock to cross the pulmonic valve. Hope this help..

[@shadowcreekranch]

Really appreciate the explanation. Once you have crossed the PV with an angled pigtail, how much further do you advance into the PA? And you then exchange for the 7Fr Swan over a 0.025" wire?

[@kerolusshehata2275]

Thank you!

[@whiteboardandmarkercardiol2787]

You are welcome. Hope this is helpful..