{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:48:57Z","timestamp":1791953337400,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Large-bore mechanical aspiration thrombectomy (MAT) for acute pulmonary embolism (PE) is thought to be less effective in patients with a component of subacute or chronic thrombus, though no studies directly compare successful and unsuccessful MAT patients. We hypothesized that unsuccessful MAT would be associated with a more subacute or chronic clinical presentation due to the presence of chronic thrombus, and that a subset of unsuccessful MAT patients would suffer unfavorable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective case-series analysis of patients treated at a tertiary care center who underwent MAT for presumed acute PE. Clinical features including duration of symptoms, presenting vitals, laboratory results, imaging, and procedural findings were compared between the successful and unsuccessful MAT patients. Adverse outcomes including in-hospital PE-related mortality were also compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The majority of unsuccessful MAT cases (79%) were attributed to chronic thrombus. Unsuccessful MAT patients presented with a longer duration of symptoms (Fisher\u2019s exact test\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04), less severe vital sign abnormalities (Shock Index 0.78 vs 1.10,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0005), and higher preprocedure pulmonary artery systolic pressure (57 vs 48 mmHg,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.06). In-hospital PE-related mortality was higher in the unsuccessful MAT group (36% vs 0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Unsuccessful MAT was mostly attributed to chronic thrombus and was associated with a less acute clinical presentation. A subset of patients that undergo unsuccessful MAT may be high risk for in-hospital mortality. A high index of suspicion for chronic thrombus is crucial when considering patients for MAT. Further study is needed to identify the patients most likely to benefit from this procedure, and those with a thrombus not amenable to MAT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x261465624","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:55:13Z","timestamp":1790398513000},"page":"718-724","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical features and outcomes of unsuccessful mechanical aspiration thrombectomy in acute pulmonary embolism"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6865-229X","authenticated-orcid":false,"given":"Sayhaan R","family":"Goraya","sequence":"first","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7970-1923","authenticated-orcid":false,"given":"S Nabeel","family":"Hyder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9512-3825","authenticated-orcid":false,"given":"Victor M","family":"Moles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhaj S","family":"Khaja","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6532-8440","authenticated-orcid":false,"given":"Geoffrey D","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029619853037"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"e_1_3_3_4_2","article-title":"2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN guideline for the evaluation and management of acute pulmonary embolism in adults: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"153","author":"Creager MA","year":"2026","unstructured":"Creager MA, Barnes GD, Giri J, et al. 2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN guideline for the evaluation and management of acute pulmonary embolism in adults: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. 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