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Emergent pulmonary embolectomy associated with clot in transit using FlowTriever aspiration device

Maria del Pilar Bayona Molano, Juana Barrera, Kinga Kwolek, Zachary Song, Daniel Lamus, Jason Salsamendi

Clot in transit (CIT) possesses a high mortality rate if left untreated hence timely management is required. Various treatment options, including endovascular procedures, are available. Currently, no consensus exists on superior treatment modality. Nevertheless, a multidisciplinary approach with a case-based evaluation seems the most appropriate. In the event of thrombolysis contraindication and hemodynamic instability, percutaneous mechanical thrombectomy should be considered. The success of the procedure is dependent on proper patient selection, as well as appropriate procedure guidance. The FlowTriever (Inari Medical Inc., Irvine, CA, USA) has proven efficacious for CIT treatment in several case reports. Based on the literature review, five out of six patients with CIT treated with the FlowTriever were discharged alive. Furthermore, the FLARE study reported an acceptable effectiveness profile in patients with Pulmonary Embolism (PE). This article presents currently available percutaneous mechanical thrombectomy alternatives focusing on the potential of the FlowTriever aspiration device.