case_images: PMC11829714_01
case_images: Initial thoracic CTPA showing bilateral PE (panel A - axial view, panel B - coronal view). CTPA: computed tomography pulmonary angiography, PE: pulmonary embolism
case_images: cureus-0017-00000077543-i01.jpg
case_images: PMC11829714_01_cureus-0017-00000077543-i01.jpg
case_images: FIG1
case_images: Given the high pre-test probability for PE, a thoracic CTPA confirmed bilateral thromboembolism with evidence of right heart strain (Figure 1).
case_images: Selective pulmonary angiography showing occlusion of the right upper lobar branch (red circle)
case_images: cureus-0017-00000077543-i02.jpg
case_images: PMC11829714_01_cureus-0017-00000077543-i02.jpg
case_images: FIG2
case_images: Angiography demonstrated a complete occlusion of the right upper lobar branch (Figure 2).
case_images: Pulmonary angiography: percutaneous thrombectomy with the assistance of a thrombus separator (red arrow)
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case_images: PMC11829714_01_cureus-0017-00000077543-i03.jpg
case_images: FIG3
case_images: Thrombus aspiration was performed (Figure 3), achieving partial revascularization (Figure 4).
case_images: Pulmonary angiography: result showing reperfusion of the treated segment (albeit with residual thrombus)
case_images: cureus-0017-00000077543-i04.jpg
case_images: PMC11829714_01_cureus-0017-00000077543-i04.jpg
case_images: FIG4
case_images: Thrombus aspiration was performed (Figure 3), achieving partial revascularization (Figure 4).
case_images: Evolution of respiratory dysfunction according to the calculation of the PaO2/FiO2 ratio throughout hospitalization. The vertical dashed red lines represent the therapies the patient underwent: the first thrombectomy and direct thrombolysis on day 1 of hospitalization, low-dose thrombolysis on the third day of hospitalization, and the second thrombectomy on the 14th day of hospitalization. PaO2/FiO2: partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration
case_images: cureus-0017-00000077543-i05.jpg
case_images: PMC11829714_01_cureus-0017-00000077543-i05.jpg
case_images: FIG5
case_images: A significant improvement in RI was observed following the second PT (Figure 5).