Percutaneous large-bore mechanical thrombectomy for macroscopic fat pulmonary embolism: a case report

TL;DR

A 73-year-old woman with a rare fat blockage in her lungs was successfully treated with a new procedure called mechanical thrombectomy.

Contribution

This is the first reported use of mechanical thrombectomy for macroscopic fat pulmonary embolism.

Findings

A percutaneous large-bore mechanical thrombectomy improved hemodynamic function in a patient with macroscopic fat pulmonary embolism.

The patient showed notable clinical improvement after the procedure.

This case suggests mechanical thrombectomy may be a viable treatment for this rare condition.

Abstract

Macroscopic fat pulmonary embolism is extremely uncommon. Most cases occur in the context of fat grafting or long bone fractures. Macroscopic fat pulmonary embolism may be associated with cardiopulmonary compromise and is associated with high mortality. Mechanical thrombectomy is an emerging technique in interventional radiology, primarily investigated as a therapeutic approach for thrombotic pulmonary embolism.

We present a case report of a 73-year-old woman with macroscopic fat pulmonary embolism after a neck of femur fracture. Initially, she had severe circulatory shock, requiring multiple vasopressors and admission to the Intensive Care Unit. A percutaneous large-bore mechanical thrombectomy was performed, after which notable improvements to haemodynamic function and overall clinical trajectory were observed.

To our knowledge, this is the first report of mechanical thrombectomy in macroscopic fat pulmonary embolism. Further research is required to better delineate the role of mechanical thrombectomy in this rare condition.

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