Minimally invasive pulmonary embolism procedure offers low mortality

Royal Oak, MI – The use of a tiny tool to pluck life-threatening

blood clots out of arteries to the lungs resulted in a high patient survival
rate, especially when compared to historical treatments such as blood thinners
or surgery, according to the largest study to date of pulmonary embolism
removal.

The FLASH (FlowTriever All-Comer Registry for Patient Safety
and Hemodynamics) study results were published recently in EuroIntervention, the
journal of the European Association of Percutaneous Coronary Interventions,
with interim results published earlier in 2022 in Catheterization & Cardiovascular
Interventions. The study reviewed the treatment of pulmonary
embolism (PE) in 800 patients cared for at 50 hospitals in the United States
between December 2018 and December 2021, including Corewell Health’s Beaumont
Hospital, Royal Oak.

The study looked at the effectiveness of a minimally invasive
device, called the FlowTriever System by Inari Medical, now available to PE
patients at Corewell Health, using a catheter threaded through a vein in the
groin to the right side of the heart and into the arteries leading to the lung.
Doctors then use a large suction device at the end of the catheter to grab the
clot. Vacuum suction pulls the clot out of the artery into the catheter and out
of the body in a process called mechanical thrombectomy.

“When we looked at
the effectiveness of this mechanical thrombectomy device compared to standard
treatments such as systemic blood thinners, thrombolytics or open surgery,
mortality risk dropped
from a historic rate of 6.5% down to 0.8% ....." said one of two Corewell Health study
investigators, Dr.
Michael Savin,
an interventional radiologist who treats patients at Corewell
Health’s Beaumont Hospital, Royal
Oak and Corewell Health’s Beaumont Hospital, Troy. “Additionally, the patients’
blood flow, cardiac function and shortness of breath improved rapidly. This
treatment potentially decreases the risk of long-term disability.”

Each year, pulmonary embolism affects up to 900,000 people in
the United States; with 10 to 30 percent of patients dying within one month of
diagnosis, according to the American Lung Association.

Pulmonary embolism occurs when blood clots, often formed in
the legs, travel through the right side of the heart and become lodged in
arteries of the lungs, cutting off blood flow. Risk factors for pulmonary
embolism include obesity, immobilization due to surgery, cancer, smoking and
COVID-19. Symptoms can include sudden shortness of breath, chest pain,
lightheadedness and a cough. The condition can damage the lungs, affect heart
function, injure major organs deprived of oxygen and ultimately lead to death.

Historically, doctors often used anti-coagulation and clot
dissolving medications to thin the blood, prevent additional clots from forming
and dissolve existing clots. However, these medications carry an increased risk
of internal bleeding and brain hemorrhage.

Study investigator Dr. Herman-Simon Kado, an interventional
cardiologist at Corewell Health’s Beaumont Hospital,
Royal Oak, said use of a mechanical device provides an alternative for
patients who cannot tolerate clot-dissolving medications that thin the blood.
About a third of the FLASH patients (32.1%) could not be treated with these
medications. The medications are not recommended for patients who are already
taking anti-coagulation medication, often cardiac patients; are over 75 years
old; who have blood pressure higher than 180/110; are pregnant; or have
recently had surgery, among other factors.

“Mechanical thrombectomy increases our ability to treat
patients for whom clot-dissolving medications are not an option,” Dr. Kado
said. “And a minimally invasive option over open surgery results in less trauma
to the patient, shorter hospital stays and faster recovery. This provides
additional opportunity for positive outcomes for our patients.”

Corewell Health has been a leader nationally for the
treatment of pulmonary embolism and a magnet hospital regionally for PE patient
transfers. The Pulmonary Embolism Response Team (PERT) formed
at Corewell Health’s Beaumont Hospital, Royal Oak, is now serving as a national
model for how to treat PE patients.