{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:05:34Z","timestamp":1794258334655,"version":"4.9.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>High-risk pulmonary embolism (PE) is associated with significant mortality. Thrombolysis is the therapy of choice, while interventional thrombectomy may be a helpful strategy in case of contraindications or failed thrombolysis. However, the procedure may be complicated by catheter-induced embolization of clots and\/or haemodynamic compromise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present a 32-year-old patient woman with fulminant pulmonary artery embolism. Despite immediate systemic thrombolysis, the patient remained in cardiogenic shock with rising lactate levels. Furthermore, floating clots were observed in the right atrium of the patient. As a rescue strategy, we performed interventional thrombectomy by using the Inari FlowTriever system supported by periinterventional veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implantation. After a successful thrombectomy, the patient recovered and showed immediate haemodynamic improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Interventional thrombectomy may be considered in patients with high-risk PE and failed thrombolytic therapy. Support by a VA-ECMO should be considered in order to prevent transient haemodynamic instability associated with accidental, catheter-induced clot mobilization from the vena cava or right atrium.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae700","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T20:01:28Z","timestamp":1735588888000},"source":"Crossref","is-referenced-by-count":4,"title":["Case report: interventional thrombectomy with haemodynamic support by veno-arterial extracorporeal membrane oxygenation as a rescue strategy in acute pulmonary embolism refractory to systemic thrombolysis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6371-3325","authenticated-orcid":false,"given":"Fuad","family":"Mahmudlu","sequence":"first","affiliation":[{"name":"Department of Cardiology, General Hospital Celle , Siemensplatz 4, Celle 29223 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel","family":"Alahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Hospital Celle , Siemensplatz 4, Celle 29223 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abderrahmen","family":"Mimoune","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Hospital Celle , Siemensplatz 4, Celle 29223 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2031-6662","authenticated-orcid":false,"given":"Eberhard","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, General Hospital Celle , Siemensplatz 4, Celle 29223 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"2025012113150179800_ytae700-B1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"key":"2025012113150179800_ytae700-B2","doi-asserted-by":"crossref","first-page":"e623","DOI":"10.4244\/EIJ-D-22-00246","article-title":"Percutaneous treatment options for acute pulmonary embolism: a clinical consensus statement by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function and the European Association of Percutaneous Cardiovascular Interventions","volume":"18","author":"Pruszczyk","year":"2022","journal-title":"EuroIntervention"},{"key":"2025012113150179800_ytae700-B3","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jcin.2018.12.022","article-title":"A prospective, single-arm, multicenter trial of catheter-directed mechanical thrombectomy for intermediate risk acute pulmonary embolism: the FLARE study","volume":"12","author":"Tu","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2025012113150179800_ytae700-B4","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1056\/NEJMoa1302097","article-title":"Fibrinolysis for patients with intermediate-risk pulmonary embolism","volume":"370","author":"Meyer","year":"2014","journal-title":"N Engl J Med"},{"key":"2025012113150179800_ytae700-B5","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1016\/j.jvir.2019.05.024","article-title":"Safety and efficacy of acute pulmonary embolism treated via large-bore aspiration mechanical thrombectomy using the Inari FlowTriever device","volume":"30","author":"Wible","year":"2019","journal-title":"J Vasc Interv Radiol"},{"key":"2025012113150179800_ytae700-B6","doi-asserted-by":"crossref","first-page":"106127","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106127","article-title":"Characterization of the \u2018white\u2019 appearing clots that cause acute ischemic stroke","volume":"30","author":"Mereuta","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2025012113150179800_ytae700-B7","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1002\/ccd.30329","article-title":"VA-ECMO-assisted aspiration thrombectomy in a patient presenting with acute massive PE with absolute contraindications to thrombolytics","volume":"100","author":"Patel","year":"2022","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025012113150179800_ytae700-B8","doi-asserted-by":"crossref","first-page":"524","DOI":"10.5935\/0103-507X.20220342-en","article-title":"Extracorporeal mechanical support and aspiration thrombectomy in treatment of massive pulmonary embolism: a case report","volume":"34","author":"Jorge","year":"2022","journal-title":"Rev Bras Ter Intensiva"},{"key":"2025012113150179800_ytae700-B9","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1024\/0301-1526\/a001019","article-title":"VA-ECMO and thrombus aspiration in a pulmonary embolism patient with cardiac arrest and contraindications to thrombolytic therapy","volume":"51","author":"Reisinger","year":"2022","journal-title":"Vasa"}],"container-title":["European Heart Journal - Case 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Isabel Gonzalez","family":"Del Hoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,12,24]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae700","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,12,24]]},"article-number":"ytae700"}}