Abstract
Background:
Pulmonary embolism response teams (PERTs) are multidisciplinary care teams that perform rapid assessment and recommendations for patients with pulmonary embolism (PE). Challenges in creating and maintaining a PERT include physician buy-in and availability at all hours. One potential solution is to share PE interventions across specialty services.
Methods:
Patients with acute PE who received a PERT consultation and subsequent mechanical thrombectomy (MT) were included in this single-center, retrospective study. Patients from January 2021 to June 2024 were divided into two cohorts: one that received MT from interventional radiology (IR) and another that received MT from vascular surgery (VS). Outcomes included 30-day mortality, bleeding, 6-minute follow-up walk distance, time to intervention, total procedure time, and complication rates.
Results:
A total of 76 patients were included in this analysis. IR and VS performed 61.8% (n = 47) and 38.2% (n = 29) of MTs, respectively. Of patients treated with MT, 46.1% (n = 35) had high-risk status and 53.9% (n = 41) had intermediate-high-risk status. In patients who received MT from IR, there was a 6.4% (three of 47) 30-day mortality rate compared to 6.9% (two of 29) from VS (p = 0.938). The occurrence of complications after MTs performed by IR and VS were 4.3% (two of 47) and 6.9% (two of 29), respectively (p = 0.792). Major procedure-related adverse events were 4.3% (two of 47) for IR and 6.9% (two of 29) for VS (p = 0.792).
Conclusion:
Outcomes of PE thrombectomy did not differ by whether the proceduralist was IR or VS. Intervention-sharing among different provider groups within PERTs could alleviate provider burden and make response team implementation more feasible.
Keywords
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