{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:11:00Z","timestamp":1778238660242,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000945","name":"Pittsburgh Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The combined use of extracorporeal cardio-pulmonary resuscitation (ECPR) and large bore mechanical thrombectomy represents an emerging strategy for patients experiencing cardiac arrest secondary to catastrophic pulmonary embolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single-center study included patients treated between January 2023 and June 2025 who experienced cardiac arrest due to catastrophic pulmonary embolism and underwent ECPR followed by large bore mechanical thrombectomy. Primary outcomes were 90-days post-discharge survival and cerebral performance category (CPC) at discharge. Secondary outcomes included support duration, complications during support, and ICU and hospital length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen patients were included. Four (27%) sustained out-of-hospital cardiac arrest, and twelve (80%) presented with pulseless electrical activity. All patients underwent large bore mechanical thrombectomy using the Inari FlowTriever System (Inari Medical, Irvine, CA) within 6\u00a0hours of arrest in the cardiac catheterization laboratory. Eight patients (53%) survived to discharge with favorable neurological outcomes (CPC 1\u20132). Seven patients died following withdrawal of care due to cerebrovascular accident or anoxic brain injury (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4), intracranial hemorrhage (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 2), or mesenteric ischemia (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1). Cerebrovascular or anoxic brain injury occurred more frequently among non-survivors (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02). No significant differences were observed in baseline characteristics, ECMO or ventilator duration, or length of stay between survivors and non-survivors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ECPR followed by large bore mechanical thrombectomy is a feasible resuscitative strategy for patients presenting with catastrophic pulmonary embolism. Larger, multicenter studies are warranted to better define outcomes and the overall impact of this combined approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251415339","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:30:36Z","timestamp":1778049036000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The utilization of large bore mechanical thrombectomy and extracorporeal pulmonary resuscitation in catastrophic pulmonary embolism: A case series"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5466-7932","authenticated-orcid":false,"given":"Shan P.","family":"Modi","sequence":"first","affiliation":[{"name":"Allegheny Health Network"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cali","family":"Clark","sequence":"additional","affiliation":[{"name":"Allegheny Health Network"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthikeyan","family":"Ranganathan","sequence":"additional","affiliation":[{"name":"Allegheny Health Network"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Khalif","sequence":"additional","affiliation":[{"name":"Allegheny Health Network"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.115.306841"},{"key":"e_1_3_5_3_2","first-page":"543","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 SV","year":"2019","unstructured":"Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory society (ERS). Eur Heart J 2020 2019; 41: 543\u2013603.","journal-title":"Eur Heart J 2020"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.10.026"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2022.100548"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.036101"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004643"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14420"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-019-01149-9"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302097"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.07.87"},{"key":"e_1_3_5_12_2","unstructured":"Interventional therapies for acute pulmonary embolism. Current status and principles for the development of novel evidence: a scientific statement from the American heart association. Circulation. (accessed 3 November 2025)."},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2019.05.024"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30329"},{"key":"e_1_3_5_15_2","first-page":"102436","article-title":"VA-ECMO supported aspiration thrombectomy for high-risk PE: a single-center experience","volume":"3","author":"Hasnie UA","year":"2024","unstructured":"Hasnie UA, Price C, Sridhar M, et al. VA-ECMO supported aspiration thrombectomy for high-risk PE: a single-center experience. J Soc Cardiovasc Angiogr Interv 2024; 3: 102436.","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32338-2"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-22-00732"},{"key":"e_1_3_5_18_2","doi-asserted-by":"crossref","unstructured":"Giri J Mahfoud F Gebauer B et al. Peerless II: a randomized controlled trial of large-bore thrombectomy versus anticoagulation in intermediate-risk pulmonary embolism 2024; 3: 101982 Epub ahead of print 1 June 2024.","DOI":"10.1016\/j.jscai.2024.101982"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251415339","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591251415339","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251415339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:46:26Z","timestamp":1778237186000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591251415339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":17,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/02676591251415339"],"URL":"https:\/\/doi.org\/10.1177\/02676591251415339","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}