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Journal Article Multicenter Study Observational Study Epublish 1 citation

PubMed: 42657006 DOI: 10.1016/j.rpth.2026.106883

Outcomes of catheter-directed mechanical thrombectomy in patients with cancer-associated pulmonary embolism: a multicenter, prospective registry.

Res Pract Thromb Haemost 10(5):106883

Authors: Marta Banaszkiewicz, Sylwia Sławek-Szmyt, Jakub Stępniewski, Paweł Kurzyna, Aneta Klotzka, Wiktor Kuliczkowski, Jacek Klaudel, Maciej Lewandowski, Marek Grabka, Marek Roik, Marcin Waligóra, Ewa Mroczek, Michał Łomiak, Szymon Darocha, Zbigniew Krasiński, Adam Torbicki, Grzegorz Kopeć, Aleksander Araszkiewicz, Marcin Kurzyna

Affiliations

  • Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Reference Lung Member, European Health Centre Otwock, Otwock, Poland. Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.
  • Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.
  • Pulmonary Circulation Centre, Department of Cardiac and Vascular Disease, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland.
  • Department of Cardiac and Vascular Diseases, St. John Paul II Hospital, Krakow, Poland.
  • Center for Innovative Medical Education, Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
  • Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Reference Lung Member, European Health Centre Otwock, Otwock, Poland. Doctoral School of Translational Medicine, Medical Centre of Postgraduate Education, Warsaw, Poland.
  • Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland.
  • Department of Cardiology, St. Adalbert's Hospital, Copernicus PL, Gdansk, Poland.
  • Department of Cardiology, Pomeranian Medical University, Szczecin, Poland.
  • 1st Department of Cardiology, Silesian Medical University, Upper Silesian Medical Centre, Katowice, Poland.
  • Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
  • Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Reference Lung Member, European Health Centre Otwock, Otwock, Poland.
  • Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Abstract

BACKGROUND

Cancer-associated pulmonary embolism (PE) is a commonplace complication that contributes to morbidity and mortality. Data of catheter-directed mechanical thrombectomy (CDMT) in patients with cancer are limited.

OBJECTIVES

To assess the efficacy and safety of CDMT in patients with intermediate-high or high-risk PE and cancer comorbidity.

METHODS

Multicenter prospective, observational study of 290 PE patients treated with CDMT using continuous vacuum aspiration thrombectomy systems. Patients were classified into 2 groups: oncologic patients (OP) and nononcologic patients (NOP). The primary safety endpoints included in-hospital all-cause mortality and procedure-related major bleeding. The primary efficacy endpoint was the change in right-to-left-ventricle (RV/LV) ratio before and 48 hours after CDMT. The efficacy and safety of CDMT were compared between OP and NOP.

RESULTS

Active cancer was observed in 18.3% (53/290) of patients with PE treated with CDMT. OP did not differ significantly from NOP in terms of baseline characteristics. After treatment, both OP and NOP demonstrated RV/LV ratio reduction by 27% (the mean change of -0.37 ± 0.22 (P < .001) in OP vs -0.31± 0.21 (P < .001) in NOP, P = .166). Major bleeding occurred in 1.9% (1/53) of OP and in 0.8% (2/237) of NOP (P = .455). The rate of all-cause in-hospital mortality reached 9.4% (5/53) in OP and 6.4% within NOP (P = .383).

CONCLUSIONS

CDMT in OP characterized an acceptable safety profile and substantial improvement in RV function, similar to those observed in NOP. Patients with cancer-related PE had similar in-hospital survival rate compared with patients without cancer, when treated with CDMT.

MeSH

Registries, Mortality, Embolism, Safety, Hemorrhage, Neoplasms, Hospital Mortality, Pulmonary Embolism, Morbidity, Thrombectomy, Catheters