Anticoagulation is mainstay therapy for patients with acute pulmonary embolism while systemic thrombolysis is reserved for those with hemodynamic instability. Over the last decade, percutaneous interventional options have entered the landscape aimed to achieve rapid pharmacomechanical pulmonary artery recanalization. The Penumbra Indigo® Aspiration System (Penumbra Inc., CA, USA) is a US FDA-approved large-bore aspiration thrombectomy device for the treatment of pulmonary embolism. Recent data has demonstrated improved radiographic end points with low rates of major adverse events in cases of intermediate-risk pulmonary embolism. In this review article, we outline device technology, applications, evidence and future directions.
Keywords: Indigo® Aspiration System; Penumbra; cardiology; critical care medicine; interventional radiology; mechanical thrombectomy; pulmonary embolism; pulmonary embolism response team; venous thromboembolism.
A pulmonary embolism, or a blood clot in the blood vessels of the lungs, can cause symptoms of chest pain and difficulty breathing. While blood thinners have been the main treatment for pulmonary embolism, procedures aimed to rapidly remove clots have become available as treatment options. In this article we review these procedural options for pulmonary embolism with a focus on the Indigo® Aspiration System by Penumbra Inc. This device has shown that it works and is very safe compared with other similar devices. In the future, more studies need to be performed to compare how well this device works compared with blood thinners alone, and whether it can lower the chances of long-term symptoms of these clots such as chronic shortness of breath and heart failure.