A meta-analysis of outcomes of aspiration thrombectomy for high and intermediate-risk pulmonary embolism

Background: Aspiration thrombectomy has gained popularity in patients with massive and submassive pulmonary embolism (PE) and having contraindications to thrombolysis. Methods: A meta-analysis was conducted including studies on aspiration thrombectomy in patients with high-risk and intermediate-risk PE. The pooled odds ratio for efficacy parameters, including change in heart rate, blood pressure and right ventricle/left ventricle (RV/LV) ratio, and safety parameters including major bleeding and stroke, was calculated using a random effects model. Results: The meta-analysis of 24 selected studies revealed that intermediate and high-risk pulmonary embolism (PE) patients demonstrated significant improvements: modified Miller score odds ratio of 10.60, mean pulmonary artery pressure reduction by 0.04 mm Hg, and an overall allcause mortality odds ratio of 0.10. Considerable heterogeneity was observed in various outcomes. Conclusion: Aspiration thrombectomy has success rates in both high-risk and intermediate-risk PE, however, procedural risks, including bleeding, must be anticipated.