Optimizing pulmonary embolism response team functionality: Outcomes of mechanical thrombectomy by interventional radiology and vascular surgery.

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.