EXTRACT-PE an “important first study” for aspiration thrombectomy in acute PE patients


Akhilesh Sista (New York, USA) talks to Interventional News at  VIVA 2019 (Vascular InterVentional Advances; 4–7 November, Las Vegas, USA) about the results of the EXTRACT-PE study, that were presented in a late-breaking clinical trial session at the meeting.

EXTRACT-PE successfully met the primary endpoints, demonstrating the safety and efficacy of the Indigo Aspiration System (Penumbra) for aspiration mechanical thrombectomy in patients with acute pulmonary embolism (PE).

Sista says that “up to this point, there had been no prospectively collected data on this new but promising device”. Catheter-directed thrombolysis and systemic thrombolysis both carry the risk of bleeding and the inconvenience of having to drip the patient with tissue plasminogen activator (tPA) over the course of time. That is why, Sista says, the purpose of the EXTRACT-PE study, was to evaluate the efficacy and safety of aspiration thrombectomy with the Indigo Aspiration System.

While Sista says that the data indicates “this is another tool in our toolbox to remove thrombus quickly in patients who need thrombus removal”, he also believes that the “scientific pulmonary embolism (PE) community” has to go beyond the RV to LV ratio and needs to look at clinical outcomes and randomise patients, both for this device and in general, to try to evaluate whether clot removal in submassive PE “is the right thing to do, and if so, in whom”.

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