Many are familiar with deep-vein thrombosis, a condition where blood clots form in the legs due to immobility or injury. However, pulmonary embolism (PE), which occurs when these clots travel to the lungs, is less well-known. PE obstructs pulmonary blood flow, stresses the heart’s right side, and hampers oxygenation of blood, making it as severe as a heart attack or stroke. It ranks as the third leading cardiovascular cause of death in the United States.
Symptoms such as shortness of breath and chest pain can be mistaken for other conditions. “It can be hard to differentiate PE from a heart attack, and as the patient, you don’t need to. Just get to the hospital,” advised Dr. Alon Yarkoni of UHS’ Structural Heart Program. Diagnosis typically involves an echocardiogram and a CT scan.
While PE is life-threatening, treatment initiation generally allows more time than heart attacks or strokes. Patients usually receive blood thinners post-diagnosis; however, some may require thrombolytics or mechanical thrombectomy using the Inari Medical FlowTriever system—a non-surgical procedure that removes clots from pulmonary arteries.
Mechanical thrombectomy has gained popularity over the past decade due to its effectiveness. Dr. Yarkoni noted that recent trials show benefits in treating acute episodes and preventing long-term complications like residual clots and reduced heart function.
Dr. Yarkoni began performing mechanical thrombectomy at UHS in March 2022 after specialized training at Henry Ford Hospital in Detroit and has since completed around three dozen cases with positive outcomes for selected patients. The procedure is covered by Medicare and major insurance plans.
The Pulmonary Embolism Response Team (PERT) evaluates candidates for mechanical thrombectomy carefully. This team includes various specialists who collaborate on treatment recommendations based on diagnostic data.
UHS pulmonologist Dr. Muhammad Imtiaz emphasized PERT’s importance: “Most PE patients become long-term pulmonary care patients.” The comprehensive team approach aids in diagnosing those unsuitable for thrombolytics due to factors like high clot burden or bleeding risks.
Ken Semanovich, 71, from Chenango Bridge experienced firsthand the benefits of PERT at UHS after developing leg pain that led to fatigue following an injury. After initial diagnosis with oral blood thinners at UHS Wilson Medical Center revealed leg clots, further tests showed lung clots too.
Dr. Yarkoni presented three options: continue oral medication, intravenous medication, or try mechanical thrombectomy—Mr. Semanovich chose the latter and felt immediate improvement post-procedure: “My fatigue went away.”
Three weeks later he resumed mowing his lawn faster than before treatment.
Individuals at risk for PE include those who are pregnant/postpartum, obese smokers using contraceptives; have prior strokes/high blood pressure/cancer; experience extended immobility (e.g., hospitalization/surgery); undergo chemotherapy treatments.
For more information about mechanical thrombectomy for PE visit nyuhs.org.
