{
  "abstract": "BACKGROUND High-risk pulmonary embolism (PE) carries significant mortality, and management becomes complex when it coexists with severe anemia and active bleeding, as thrombolysis is then contraindicated. We report the case of a patient with high-risk PE complicated by severe anemia (hemoglobin 41 g/L) and active uterine bleeding from adenomyosis. CASE REPORT A 48-year-old woman presented with haemodynamic instability (blood pressure 74/47 mm Hg), critical anemia (hemoglobin 41 g/L), and a 3-year history of irregular vaginal bleeding from adenomyosis. Computed tomography (CT) pulmonary angiography confirmed bilateral PE with right pulmonary artery main-trunk occlusion; echocardiography showed severe pulmonary hypertension, and duplex ultrasound showed extensive left lower-limb deep vein thrombosis. Thrombolysis was contraindicated. Emergency percutaneous aspiration thrombectomy was performed using large-bore catheters (22F, 20F, 16F) with concurrent inferior vena cava filter placement, reducing pulmonary artery pressure from 51/23 to 34/12 mm Hg; the estimated blood loss, quantified from filtered aspirate, was approximately 100 mL. Adjuncts included transfusion of 13 units of packed red cells, dilatation and curettage, gonadotropin-releasing hormone agonist therapy, and titrated anticoagulation. At discharge after a 24-day hospitalization she was hemodynamically stable, and free of dyspnea, with resolved edema and hemoglobin 72 g/L, on oral rivaroxaban. CONCLUSIONS In this thrombolysis-contraindicated patient, aspiration thrombectomy with inferior vena cava filter placement was a feasible rescue strategy that achieved rapid hemodynamic and angiographic improvement without thrombolysis, with palliative rather than curative intent. As a single case, it cannot establish comparative safety or efficacy, and broader conclusions regarding efficacy cannot be drawn. It illustrates a potentially useful approach in similarly complex scenarios where coordinated multidisciplinary care is essential.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China.",
    "Hebei Key Laboratory of Pathogenic Mechanisms and Diagnosis & Treatment Technologies for Lung Microbiome, First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Okba Saoudi",
      "orcid": "0009-0003-6400-2873"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Bu Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7bnr6j03cg9b5.bib",
  "cited_by": 0,
  "doi": "10.12659/ajcr.954225",
  "fulltext_url": "https://europepmc.org/articles/PMC13700543",
  "id": "7bnr6j03cg9b5",
  "issns": [
    "1941-5923"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902551",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7205008342",
  "pdf_url": "https://europepmc.org/articles/PMC13700543?pdf=render",
  "pmcid": "PMC13700543",
  "pmid": "42902551",
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7bnr6j03cg9b5.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42902551",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902551"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2724|Venous Thromboembolism Diagnosis and Management",
      "subfield": "general"
    }
  ],
  "title": "Aspiration Thrombectomy for High-Risk Pulmonary Embolism With Life-Threatening Anemia and Active Uterine Bleeding: A Case Report.",
  "title_text": "Aspiration Thrombectomy for High-Risk Pulmonary Embolism With Life-Threatening Anemia and Active Uterine Bleeding: A Case Report.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:32Z",
  "url": "https://research.draconitic.com/paper/7bnr6j03cg9b5",
  "venue": "The American journal of case reports",
  "versions": []
}