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Cohort studyClinical research in cardiology : official journal of the German Cardiac Society · 2026

Aspirated thrombus weight and volume are not associated with improvements in hemodynamics after large-bore mechanical thrombectomy in pulmonary embolism.

Felix Götzinger, Lucas Lauder, Patricia Perez Navarro … Felix Mahfoud

Internal MedicineCohort study

Amount of thrombus removed did not correlate with pulmonary artery pressure improvement.

Aspirated thrombus weight and volume are not associated with improvements in hemodynamics after large-bore mechanical thrombectomy in pulmonary embolism.

Felix Götzinger … Felix Mahfoud

Clinical research in cardiology : official journal of the German Cardiac Society · 2026

Background

Large-bore mechanical thrombectomy (large-bore mechanical thrombectomy) is a catheter-directed therapy for acute pulmonary embolism (pulmonary embolism).

Purpose

The aim was to evaluate the impact of aspirated thrombus weight and volume on outcomes after large-bore mechanical thrombectomy.

Methods

This prospective, open-label, single-arm, single-center registry study included 48 patients undergoing large-bore mechanical thrombectomy using the FlowTriever system (Inari Medical/Stryker, Irvine, CA, USA).

n = 48 patients

ρ = 0.10

Results

ρ = 0.10

clot amount removed didn't predict pressure improvement

n = 48 patients

More results

Thrombus material was available in 48 patients (31% women), of which 41 presented with intermediate-risk and 7 with high-risk pulmonary embolism.

More results

Large-bore mechanical thrombectomy resulted in significant reductions in systolic pulmonary artery pressures (sPAP) intraprocedurally (- 12.8 ± 8.3 mmHg, p < 0.001), with a further invasively measured decrease through 3 months (- 9.6 ± 10.6 mmHg, p < 0.001).

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Conclusion

Aspirated thrombus weight and volume were not associated with improvements after large-bore mechanical thrombectomy, suggesting that, beyond mechanical obstruction, additional mechanisms potentially including paracrine and endocrine effects of thrombus material may contribute to acute and chronic pulmonary embolism-related cardiopulmonary dysfunction.

Post

Aspirated thrombus weight and volume are not associated with improvements in hemodynamics after large-bore mechanical thrombectomy in pulmonary embolism.

Amount of thrombus removed did not correlate with pulmonary artery pressure improvement.

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