1Ayden Jacob,2Nadeem Muallem. 5Geoffrey Lindblad, 3,4Abass Chamsuddin

1Aidoc Medical, 2Envision Healthcare Services, Department of Radiology, 3University of Beirut, 4University of Balamand, St. George University Hospital, 5Aventura Medical Center


This study evaluates the technical parameters and clinical outcomes in patients with pulmonary embolism treated with mechanical thrombectomy using the Penumbra’s Indigo Aspiration CAT 12 System.

Material(s) and Method(s):

A single-center retrospective analysis of patients undergoing mechanical thrombectomy from January 2019 to December 2020 was conducted. Computed tomography angiography was utilized to delineate submassive from massive pulmonary embolism. Patient demographics, postoperative complications, comorbidities, and duration of procedure was analyzed. 30-day readmission rates, length of stay, mortality and intensive-care unit visits were assessed.


Between December 1, 2020 and December 1st, 2021, 26 patients underwent mechanical thrombectomy with the Penumbra Indigo CAT 12 System for the treatment of submassive (50%) and massive (50%) pulmonary embolism. Cat 12 is a large-lumen aspiration catheter that incorporates a laser-cut hypotubebased catheter. Saddle embolus was present in 42% of patients. The mean age was 66 (range 29-92). 58% of patients were male and 42% female. 70% of patients had right heart strain. 4 patients were Covid-19 positive, and 66% had a history of hypertension. Mean in-patient length of stay was 4.36 days (range 3-12). The average duration of procedure was 54 minutes, fluoroscopy time 17 minutes, and fluoroscopic dose 215 mGy. 3/26 patients required an ICU overnight stay. 1 patient experienced in-patient mortality. All-cause 30-day readmission rate was 19%.


Our data demonstrate that extirpation of clot in the treatment of pulmonary embolism using the Penumbra’s Indigo Aspiration CAT 12 System is an attractive alternative to catheter directed thrombolytics. The short procedure time, rapid return to normal and low complication rate makes it a potential gold standard candidate for treatment of pulmonary embolism.