A retrospective tertiary-centre case-series analysis compared successful versus unsuccessful mechanical aspiration thrombectomy for presumed acute pulmonary embolism. Chronic thrombus accounted for 79% of unsuccessful cases. Unsuccessful cases had longer symptom duration (p = 0.04) and a lower presenting Shock Index (0.78 versus 1.10; p = 0.0005). Preprocedure pulmonary artery systolic pressure was numerically higher with unsuccessful thrombectomy (57 versus 48 mmHg; p = 0.06). In-hospital PE-related mortality was higher in the unsuccessful group (36% versus 0%; p = 0.01).
Unsuccessful thrombectomy was associated with chronic thrombus, a less acute presentation, and higher in-hospital PE-related mortality. These observational findings do not establish that procedural failure caused the mortality difference.
Study limitation: The retrospective, single-centre comparison is vulnerable to confounding; sample size and confidence intervals are not reported in the abstract.
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