Quality and rapidity of anticoagulation in patients with acute pulmonary embolism undergoing mechanical thrombectomy
Robert Zhang, Alvin M. Ho, Lindsay Elbaum, Allison Greco, Sylvie Hall, Radu Postelnicu, Vikramjit Mukherjee, Muhammad Haisum Maqsood, Norma Keller, Carlos L. Alviar, Sripal Bangalore
Abstract
The primary objective of our study was to determine the proportion of intermediate-risk PE patients undergoing mechanical thrombectomy (MT) who achieved therapeutic anticoagulation (AC) at the time of the procedure. The salient findings of our study showed that only a minority of patients (14.3%) were in the therapeutic range by ACT at the time of MT (primary outcome). Furthermore, in this higher-risk PE cohort selected for MT, 18.2% of patients were subtherapeutic after initially reaching therapeutic AC, 43% experienced supratherapeutic AC at some point before MT, and less than half (43%) attained therapeutic AC at 6 hours, highlighting the necessity for optimizing anticoagulation practices in acute PE.