The occlusion of small lung arteries is the main cause of the reduction in blood flow in patients with acute pulmonary embolism. The more occlusions that a patient has, the lower the chances of survival. Patients who survive may, over some time, be highly prone to developing chronic thromboembolic pulmonary hypertension (CTEPH), which is a life-threatening condition due to increased blood pressure in the lungs. Occlusions are usually treated by relieving the obstructions in both large and small arteries. Now, new research reveals that a novel catheter which has already proven effective in reducing blockages in lung arteries, can also reduce blockages in the smaller segmental pulmonary artery branches which are ultimately responsible for oxygenating the blood in the lungs.

The new study by researchers at the Lewis Katz School of Medicine at Temple University (Philadelphia, PA, USA) which examined the BASHIR Endovascular Catheter from THROMBOLEX, Inc. (New Britain, PA, USA) further demonstrated a correlation between less blockages in the small lung arteries and functional recovery of the right ventricle of the heart, which pumps blood into the main pulmonary artery of the lungs. Notably, the BASHIR catheter was also associated with significantly lower bleeding rates compared to other devices, marking an essential advancement in the treatment of acute pulmonary embolism.

The BASHIR catheter is a slender, tube-shaped device featuring a helical basket with six mini-infusion catheters at its tip. This design allows the basket, when expanded within a clot in a large blood vessel, to create new channels through which blood can flow, carrying the body's natural clot-dissolving agents and thereby speeding up the breakdown of the clot. The new study revealed that 48 hours after treatment with the BASHIR catheter, there was a notable reduction in blockages not only in the segmental arteries but also in the proximal branches of the pulmonary artery. These reductions occurred even in arteries located away from where the infusion basket was deployed, facilitating enhanced blood flow and aiding the healing process of the right ventricle. Going forward, the researchers aim to delve into the mechanisms driving the observed decrease in arterial blockage. Further extensive trials are anticipated to more comprehensively understand the BASHIR catheter's impact on patient outcomes, including survival rates and the potential reduction in the incidence of CTEPH.

“Blockages in these smaller, distal pulmonary arteries have never previously been explored in patients treated for acute pulmonary embolism,” explained Riyaz Bashir, MD, FACC, Professor of Medicine, Director of Vascular and Endovascular Medicine in the Section of Cardiology, Department of Medicine at the Lewis Katz School of Medicine and Temple University Hospital, co-inventor of the BASHIR Endovascular Catheter. “We suspect that the improvements in blood flow are due to both the expansion of the basket and the flow of the body's clot dissolving molecules into the clot, which cause the blockage to shrink. As the volume of blood flow improved, right ventricular function also improved, which could translate to better survival.” 

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