Mechanical Thrombectomy for a Clot in Transit With Adherence to the Tricuspid Valve.
clot in transit
mechanical thrombectomy (mt)
reperfusion therapy
right heart thrombus
submassive pulmonary embolism
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
accepted:
07
10
2023
medline:
8
11
2023
pubmed:
8
11
2023
entrez:
8
11
2023
Statut:
epublish
Résumé
This case report investigates the management of a clot in transit (CIT), a rare but possibly life-threatening condition discovered in a small percentage of pulmonary embolism (PE) cases. CITs are thrombi lodged within the right-side heart chambers or the major veins, and there are currently no universal guidelines for their management though the literature has shown reduced mortality with reperfusion therapy compared to anticoagulation alone. In this case, a 96-year-old male who presented with a submassive PE was initially stabilized with anticoagulation and was then discovered to have a CIT with adherence to the tricuspid valve. The patient underwent a successful mechanical thrombectomy using the Inari FlowTriever (Inari Medical, Irvine, CA), an FDA-approved device for CIT removal. Overall, this manuscript supports this percutaneous intervention in intermediate to high-risk PE patients with concomitant CIT, offering an alternative to thrombolysis and cardiothoracic surgery, which carry their own risks. Furthermore, the unique characteristic of the CIT in this patient suggests a potential for further investigation into the diversity of CIT morphology and its significance.
Identifiants
pubmed: 37936985
doi: 10.7759/cureus.46636
pmc: PMC10627110
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e46636Informations de copyright
Copyright © 2023, Kim et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Pulm Circ. 2022 Apr 25;12(2):e12080
pubmed: 35514771
N Engl J Med. 2014 Apr 10;370(15):1402-11
pubmed: 24716681
Clin Case Rep. 2021 Jan 21;9(3):1241-1246
pubmed: 33768819
Eur Respir J. 2016 Nov;48(5):1377-1385
pubmed: 27799388
Cardiovasc Interv Ther. 2013 Apr;28(2):188-92
pubmed: 23076817
Crit Ultrasound J. 2017 Dec;9(1):14
pubmed: 28620869
Cardiovasc Intervent Radiol. 2015 Aug;38(4):1021-4
pubmed: 25189664
Chest. 2002 Mar;121(3):806-14
pubmed: 11888964
J Am Coll Cardiol. 2003 Jun 18;41(12):2245-51
pubmed: 12821255
Cureus. 2022 Aug 27;14(8):e28481
pubmed: 36176887
Vasc Med. 2015 Apr;20(2):131-8
pubmed: 25832601
Am J Med. 2017 May;130(5):588-595
pubmed: 28011316