Extracorporeal Life Support in Mechanical Pulmonary Embolism Thrombectomy: A Literature Review and A Case Report

Abstract

Introduction: Pulmonary embolism (PE) is the third leading cause of cardiovascular deaths in the United States, with over 100,000 deaths annually. This condition results from blood clots, typically originating as deep vein thrombosis, that dislodge and obstruct pulmonary arteries. This blockage can severely reduce oxygenated blood flow to the lungs and increase pressure on the heart, leading to potentially fatal complications. Current treatments include anticoagulation and thrombolytic therapy, but they may not be sufficient for severe cases. This thesis investigates the use of extracorporeal life support (ECLS) in conjunction with mechanical thrombectomy as a treatment for severe PE cases, evaluating its efficacy and safety through a meta-analysis and a detailed case report. Methods: The study was divided into a comprehensive review of existing literature and a case report. The review will outline outcomes from multiple studies that applied ECLS and mechanical thrombectomy for PE, focusing on mortality rates, procedural success, and postoperative recovery. The case report described a specific instance of ECLS used in conjunction with a mechanical thrombectomy device in a patient with acute, massive PE, detailing the procedural techniques and outcomes. Results: The comprehensive review found that combining ECLS with mechanical thrombectomy has substantial survival rates and procedural success compared to traditional treatments alone. The case report illustrated successful removal of a substantial pulmonary clot using ECLS, which stabilized the patient’s condition and significantly improved their recovery time. Conclusions: The integration of ECLS with mechanical thrombectomy provides a promising treatment option for severe PE, potentially improving patient outcomes and survival rates. This combination allows for rapid clot removal while maintaining hemodynamic stability during the procedure. The findings support further research and consideration of this combined approach as a standard treatment for severe cases of PE.