Resource Utilization and Outcomes With Penumbra’s CAVT in Intermediate-Risk PE Patients Compared to Other Treatment Modalities

November 4, 2024—A nationwide retrospective study evaluated health care resource utilization and outcomes among patients with intermediate-risk pulmonary embolism (PE) treated with computer-assisted vacuum thrombectomy (CAVT; Penumbra, Inc.) compared to anticoagulation (AC), catheter-directed thrombolysis (CDT), or other mechanical thrombectomy (MT) in the United States.

Parag J. Patel, MD, presented the findings in the second late-breaking clinical trials session at VIVA24, the 22nd annual Vascular InterVentional Advances annual vascular education symposium held by The VIVA Foundation on November 3-6 in Las Vegas, Nevada.

As summarized in the VIVA24 press release, the study investigators used data from the Vizient clinical database to identify adult inpatients with intermediate-risk PE discharged between July 1, 2020, and September 30, 2023. ICD-10—International Classification of Diseases, Tenth Revision—procedure codes were used to identify treatment modalities.

A total of 2,060 patients were propensity matched 1:1 to equate 515 CAVT patients to AC, CDT, and MT patients using demographics, Elixhauser Comorbidity Index, payer, and hospital type.

The VIVA24 press release stated that the investigators reported the following key results:

• CAVT patients experienced significantly shorter length of stay (LOS; 4.6 ± 3.2 days) compared to AC (6.2 ± 3.7 days), CDT (7.1 ± 4.4 days), and MT (7 ± 4.6 days) patients (P < .0001).
• Postprocedure LOS was shorter for CAVT patients (3.8 ± 3.2 days) compared to CDT (6.1 ± 4.3 days; P < .0001) or MT (6.2 ± 4.5 days; P < .0001) patients.
• Postprocedure intensive care unit (ICU) utilization was lower in the CAVT group compared to the CDT group (44.3% vs 82.7%; P < .0001), with a shorter mean ICU stay (0.7 ± 1.3 days vs 1.6 ± 1.5 days; P < .0001).
• CAVT patients had fewer composite complications compared to MT patients (1.2% vs 4.1%; P = .0034) and had a reduced incidence of acute kidney injury developing during the hospitalization compared to the MT (1.9% vs 4.9%; P = .0099) and CDT groups (1.9% vs 4.5%; P = .0214).
• No differences were observed between CAVT and the other groups for in-hospital mortality, 30-day all-cause mortality, and PE-related readmissions.

CAVT for the treatment of intermediate-risk PE led to significant reduction of hospital LOS and fewer complications without increasing mortality or readmissions compared to AC, CDT, and other MT, concluded the VIVA24 press release.