{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T11:46:21Z","timestamp":1782560781856,"version":"3.54.5"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Saddle pulmonary embolism (PE) complicated by right atrial thrombus in transit is an infrequent but highly lethal condition. Standard treatments such as systemic thrombolysis or surgical embolectomy carry significant risks, particularly in elderly or comorbid patients. We describe the case of a 76-year-old man with spina bifida, cauda equina syndrome, chronic immobility, and multiple comorbidities who presented in shock. Imaging revealed a large saddle PE with mobile right atrial thrombus and right ventricular strain. Given prohibitive surgical risk and contraindications to thrombolysis due to recent spinal infection and acute kidney injury, and high bleeding risk, he underwent percutaneous suction thrombectomy using the FlowTriever system. Large thrombus burden was successfully removed from both the right pulmonary artery and right atrium, with restoration of flow and hemodynamic stabilization. He was transitioned to long-term anticoagulation and discharged in stable condition. This case highlights the role of dual-site suction thrombectomy as a life-saving option when conventional therapies are contraindicated.<\/jats:p>","DOI":"10.1093\/omcr\/omag083","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:44:15Z","timestamp":1777031055000},"source":"Crossref","is-referenced-by-count":0,"title":["Simultaneous saddle pulmonary embolism and right atrial thrombus managed with ICE-guided dual suction Thrombectomy"],"prefix":"10.1093","volume":"2026","author":[{"given":"Ibraheem","family":"Sabah","sequence":"first","affiliation":[{"name":"St. Joseph's University Medical Center , Paterson, NJ ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0704-952X","authenticated-orcid":false,"given":"Sakeena","family":"Saife","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University , Nablus ,","place":["Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6397-8033","authenticated-orcid":false,"given":"Ahmad","family":"Nouri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University , Nablus ,","place":["Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamim","family":"Khaddash","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center , Danville, PA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bhanushali","sequence":"additional","affiliation":[{"name":"Temple University , Philadelphia, PA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Khaddash","sequence":"additional","affiliation":[{"name":"St. Joseph's University Medical Center , Paterson, NJ ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayez","family":"Shamoon","sequence":"additional","affiliation":[{"name":"St. Joseph's University Medical Center , Paterson, NJ ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026062707164625100_ref1","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1002\/ccd.30091","article-title":"Percutaneous mechanical thrombectomy in a real-world pulmonary embolism population: interim results of the FLASH registry","volume":"99","author":"Toma","year":"2022","journal-title":"Catheter Cardiovasc Interv"},{"key":"2026062707164625100_ref2","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.4244\/EIJ-D-22-00732","article-title":"Acute outcomes for the full US cohort of the FLASH mechanical thrombectomy registry in pulmonary 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thrombectomy with the FlowTriever for pulmonary embolism with right heart thrombi: a retrospective two centres study","volume":"4","author":"Bonello","year":"2024","journal-title":"Eur Heart J Open"},{"key":"2026062707164625100_ref6","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1002\/ccr3.3739","article-title":"Emergent mechanical thrombectomy for right atrial clot and massive pulmonary embolism using flowtriever","volume":"9","author":"Bayona Molano M","year":"2021","journal-title":"Clin Case Reports"},{"key":"2026062707164625100_ref7","doi-asserted-by":"publisher","first-page":"e7390","DOI":"10.1002\/ccr3.7390","article-title":"Becker muscular dystrophy and successful intervention with mechanical thrombectomy of right atrial clot-in-transit with pulmonary embolism","volume":"11","author":"Haque","year":"2023","journal-title":"Clin Case Reports"},{"key":"2026062707164625100_ref8","doi-asserted-by":"publisher","DOI":"10.12890\/2022_003355","article-title":"Clot In transit in a patient with protein S deficiency","volume":"9","author":"Kashfi","year":"2022","journal-title":"Eur J Case Rep Intern Med"},{"key":"2026062707164625100_ref9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.clinimag.2021.08.017","article-title":"AngioVac aspiration of right atrial cardiac pacemaker lead-associated thrombus with concurrent PE under fluoroscopic and transesophageal echocardiographic guidance: a multidisciplinary collaboration for improved patient outcome","volume":"81","author":"Yu","year":"2022","journal-title":"Clin Imaging"},{"key":"2026062707164625100_ref10","doi-asserted-by":"publisher","first-page":"e70296","DOI":"10.1002\/rcr2.70296","article-title":"Percutaneous Thrombectomy using AngioJet in acute pulmonary embolism with clot in transit","volume":"13","author":"Siddiqui","year":"2025","journal-title":"Respirol Case Rep"},{"key":"2026062707164625100_ref11","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1002\/ccd.29391","article-title":"Catheter directed embolectomy of right atrial clot in transit-a case series","volume":"97","author":"Verma","year":"2021","journal-title":"Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv"},{"key":"2026062707164625100_ref12","volume-title":"Percutaneous Right Atrial Thrombectomy Using Flow Triever (Inari) and En Snare Endovascular System: A Safe Alternative to Surgical Approach - Report of Two Cases","author":"Auctores"}],"container-title":["Oxford Medical Case 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