Browsing by Author "Pebror, Travis"

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    Ablative Therapy in Non-HCC Liver Malignancy
    (MDPI, 2023-02-14) Robinson, Tyler P.; Pebror, Travis; Krosin, Matthew E.; Koniaris, Leonidas G.; Surgery, School of Medicine
    Surgical extirpation of liver tumors remains a proven approach in the management of metastatic tumors to the liver, particularly those of colorectal origin. Ablative, non-resective therapies are an increasingly attractive primary therapy for liver tumors as they are generally better tolerated and result in far less morbidity and mortality. Ablative therapies preserve greater normal liver parenchyma allowing better post-treatment liver function and are particularly appropriate for treating subsequent liver-specific tumor recurrence. This article reviews the current status of ablative therapies for non-hepatocellular liver tumors with a discussion of many of the clinically available approaches.
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    Large-bore aspiration thrombectomy for the treatment of pulmonary embolism in octogenarians
    (Springer, 2025-01-22) Masterson, Reid; Pebror, Travis; Gauger, Andrew; Schmitz, Adam William; Butty, Sabah David; Radiology and Imaging Sciences, School of Medicine
    Purpose: To evaluate outcomes in patients aged ≥ 80 years following large-bore aspiration thrombectomy (LBAT) for the treatment of pulmonary embolism (PE). Materials and methods: All patients ≥ 80 years of age with PE treated via LBAT at a single center were analyzed from September 2019 - August 2024. This included the octogenarian subgroup from a recently published retrospective analysis assessing all PE patients treated with LBAT at our center between September 2019 and January 2023. The following outcomes were evaluated: technical success, change in several hemodynamic measures including pulmonary artery pressure (PAP) and right ventricle to left ventricle ratio (RV to LV ratio), length of hospital and intensive-care-unit (ICU) stay, procedure-related complications, and 7- and 30-day mortality. Results: Forty-eight patients aged ≥ 80 years underwent LBAT procedures for PE. Technical success was achieved in 46 cases (95.8%). The mean reduction in mean PAP was 3.6 mmHg. The mean reduction in RV to LV ratio was -0.42. The mean length of postprocedural hospital and ICU stays were 5.7 ± 3.6 days and 1.0 ± 1.6 days, respectively. There were 2 procedural complications, 1 pulmonary vascular injury involving a pulmonary artery pseudoaneurysm and 1 decompensation involving hypotension requiring vasopressor support. There were no major bleeding complications or cardiac injuries. All-cause mortality was 2.1% (n = 1) at 7 days and 6.3% (n = 3) at 30 days post procedure. PE-related mortality was 2.1% (n = 1) at 30 days. Conclusion: LBAT is a technically feasible procedure for the treatment of PE in octogenarian patients and has a favorable preliminary safety and mortality profile.
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    Large-bore Aspiration Thrombectomy with the FlowTriever System for the Treatment of Pulmonary Embolism: A Large Single-Center Retrospective Analysis
    (Springer, 2024) Pebror, Travis; Schmitz, Adam William; Gauger, Andrew; Masterson, Reid; Butty, Sabah David; Radiology and Imaging Sciences, School of Medicine
    Purpose: Evaluate the outcomes of patients undergoing large-bore aspiration thrombectomy for the treatment of pulmonary embolism at a large university medical center. Materials and methods: All patients treated for pulmonary embolism with the FlowTriever System (Inari Medical, Irvine, CA) between September 2019 and January 2023 were retrospectively analyzed. The primary safety and effectiveness outcomes included 7- and 30-day all-cause mortality, major bleeding, procedure-associated clinical decompensation, pulmonary vascular or cardiac injury, and pulmonary artery pressure reduction. Additional outcomes included technical success (completing thrombectomy with the device as intended), changes in hemodynamics and supplemental oxygen requirements, and postprocedural intensive care unit stay. Results: A total of 286 patients were identified. The mean age was 60.5 years, and 90.9% of patients presented with intermediate-risk pulmonary embolism. Technical success was achieved in 96.9% (n = 277) of cases. The average reduction in mean pulmonary arterial pressure was 6.8 mmHg, from 28.7 ± 9.0 to 21.9 ± 8.0 mmHg (p < 0.0001). Two major bleeds (0.7%), 2 pulmonary vascular injuries (0.7%), and 4 (1.4%) procedure-associated decompensations were reported, but no device-related deaths occurred. The mean post-procedure intensive care unit stay was 2.0 ± 4.1 days, and 49.3% of patients had no postprocedural intensive care unit admittance. The overall 7-day and 30-day all-cause mortality rates were 2.4% and 6.7%, respectively, with a 30-day pulmonary embolism-related mortality rate of 3.5%. Conclusion: This non-industry-sponsored single-center analysis of large-bore aspiration thrombectomy in a large population corroborates the findings of other studies and confirms that this approach is safe and effective for the treatment high- and intermediate-risk pulmonary embolism.