• Masashi Yoshida, Ichiro Inoue, Takuji Kawagoe, Masaharu Ishihara, Yuji Shimatani, Satoshi Kurisu, Kengo Fukushima Kusano, and Tohru Ohe.
• Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan. myoshid@viola.ocn.ne.jp
• Catheter Cardiovasc Interv. 2006 Jul 1; 68 (1): 112-7.

BackgroundAlthough thrombolysis is a standard therapy in cases of pulmonary embolism (PE), fatal outcome is often observed. We designed and investigated the efficacy of a novel percutaneous catheter therapy, rotational bidirectional thrombectomy (ROBOT), for PE.Methods And ResultsEighteen patients with acute massive PE (Miller score > or = 20) were included in this study. We separated them into two groups [group A (n = 10), thrombolysis; group B (n = 8): thrombolysis and ROBOT or ROBOT alone]. There was no difference in the hemodynamic indices between the groups at diagnosis. ROBOT was designed to fragment emboli by rotating a regular pigtail catheter. Three deaths occurred in group A because of hemodynamic impairment, but there was no death in group B. One day after treatment, systolic pulmonary artery pressure had decreased from 53 +/- 8 to 30 +/- 8 mm Hg (P < 0.05) in group B and from 54 +/- 5 to 42 +/- 19 mm Hg (NS) in group A. The hospitalization period in group B was shorter than that in group A (17 +/- 6 vs. 27 +/- 10 days, P < 0.05).ConclusionROBOT therapy results in a significant, rapid improvement in the hemodynamic situation and in a better outcome than conventional therapy in patients with acute massive pulmonary embolism.Copyright 2006 Wiley-Liss, Inc.

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