Effect of Filtered Blood Return on Outcomes of Pulmonary Aspiration Thrombectomy.

OBJECTIVES: Although filtered blood reinfusion (FBR) can be implemented during aspiration thrombectomy for pulmonary embolism (PE), the effectiveness and risks of this technique remain unknown. The purpose of this study was to assess how utilization of FBR affects procedural outcomes. MATERIALS AND METHODS: A total of 171 patients who underwent aspiration thrombectomy for intermediate-high or high risk PE between December 2018 and September 2022 were included, 84 of whom underwent thrombectomy with FBR and 87 without. Demographic data, vital signs, laboratory values, procedural details, pulmonary arterial pressures, transfusion needs, length of hospital stay, and procedure-related complications were recorded. RESULTS: The groups did not differ at baseline, other than the FBR cohort having a higher percentage of females. There was no significant difference in post-procedural vitals or pulmonary arterial pressure. Mean fluoroscopy time and volume of IV contrast were lower in the FBR cohort. The drop in hemoglobin was lower in the FBR group at both 12 (FBR: -1.065; no FBR: -1.742, P: >0.001) and 24 hrs (FBR: -1.526; no FBR: -2.380, P: >0.001) post procedure; accordingly, fewer patients required transfusions in the FRB cohort (FBR: 8; no FBR: 20, P: 0.016). There was no difference in the number or severity of adverse events or duration of Intensive Care Unit or hospital admission. CONCLUSIONS: FBR use during aspiration pulmonary thrombectomy reduces blood loss and transfusion requirements but has no significant effect on surrogate markers of procedural success or adverse event rates.

Single-cell analysis of endometriosis reveals a coordinated transcriptional programme driving immunotolerance and angiogenesis across eutopic and ectopic tissues.

Endometriosis is characterized by the growth of endometrial-like tissue outside the uterus. It affects many women during their reproductive age, causing years of pelvic pain and potential infertility. Its pathophysiology remains largely unknown, which limits early diagnosis and treatment. We characterized peritoneal and ovarian lesions at single-cell transcriptome resolution and compared them to matched eutopic endometrium, unaffected endometrium and organoids derived from these tissues, generating data on over 122,000 cells across 14 individuals. We spatially localized many of the cell types using imaging mass cytometry. We identify a perivascular mural cell specific to the peritoneal lesions, with dual roles in angiogenesis promotion and immune cell trafficking. We define an immunotolerant peritoneal niche, fundamental differences in eutopic endometrium and between lesion microenvironments and an unreported progenitor-like epithelial cell subpopulation. Altogether, this study provides a holistic view of the endometriosis microenvironment that represents a comprehensive cell atlas of the disease in individuals undergoing hormonal treatment, providing essential information for future therapeutics and diagnostics.