Extracorporeal Membrane Oxygenation Combined With Mechanical Thrombectomy Versus Extracorporeal Membrane Oxygenation Alone for High-Risk Pulmonary Embolism: A Systematic Review and Meta-analysis
Authors' conclusion
Pooled estimates were imprecise, and the most methodologically robust studies available did not establish a statistically significant mortality benefit.
Study context
- Population
- Adults with high-risk pulmonary embolism (PE) requiring VA-ECMO support
- Participants
- 2,824 adults · 4 observational studies
- Comparison
- VA-ECMO plus catheter-based mechanical thrombectomy vs VA-ECMO alone
- Outcome
- In-hospital mortality (pooled, 2 studies, n = 47)
Pooled result
As reported in the abstract
Pooled OR for in-hospital mortality (95% CI, 0.01-13.59); imprecise, very wide CI
0.36
Further pooled results
90-day mortality (pooled, 2 studies)
- Pooled OR for 90-day mortality (95% CI, 0.02-10.66); imprecise, very wide CI
- 0.43
- Very low certainty of evidence
In-hospital mortality, nationwide database study (n = 2,285)
- Adjusted OR for in-hospital mortality (95% CI, 0.47-1.19); not statistically significant
- 0.75
90-day mortality with early mechanical reperfusion, international multicentre cohort (n = 492)
- HR (95% CI, 0.45-1.03); not statistically significant
- 0.68
Hospital and ICU LOS
- Shorter in the ECMO-MT group
Safety
Major bleeding
- Did not differ between groups
Original publication
Extracorporeal Membrane Oxygenation Combined With Mechanical Thrombectomy Versus Extracorporeal Membrane Oxygenation Alone for High-Risk Pulmonary Embolism: A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth. Published 31 August 2026. doi:10.
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