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Insights into Imaging
Fig. 11 | Insights into Imaging

Fig. 11

From: Pathophysiology of right ventricular failure in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension: a pictorial essay for the interventional radiologist

Fig. 11

A 44-year-old male with a left lower extremity DVT after trauma presenting with massive PE, 8 days after initiation of anticoagulation for the DVT. Patient was hypotensive with a BP of 78/45 and troponin I elevation of 0.83 ng/mL. a CTA demonstrates a saddle pulmonary embolus (white arrow) and increased RV/LV ratio with blue calipers demonstrating the diameter of the RV and the red calipers demonstrating the diameter of the LV. b Fluoroscopic images of aspiration thrombectomy. A 90 cm 8Fr Sheath (white arrow) through which is passed an Indigo CAT-8 thrombectomy device (black arrowhead, Indigo, Penumbra, Alameda, CA, USA). Black closed arrow demonstrates a safety wire to stabilize access to the left pulmonary artery. Black open arrow demonstrates the Indigo separator to clear thrombus from the opening of the catheter. c Pulmonary angiogram demonstrates before and after catheter-directed therapy pictures. Arrow demonstrates improved perfusion to the lower lobe. d CTA demonstrates before and after catheter-directed therapy images with improvement in thrombus burden and before and after catheter-directed therapy images with improvement in RV/LV ratio

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