Overview

Evaluation of initial safety and clinical feasibility of the Viper Catheter System for thrombectomy in acute submassive pulmonary embolism (PE).

Eligibility

Asterisks indicate entry criteria that can be evaluated during prescreening without

        obtaining informed consent as they are part of standard of care PE management. Asterisks in
        parenthesis () indicate entry criteria that can be evaluated during prescreening without
        obtaining informed consent at Sites that routinely perform CTA as part of standard of care
        in PE management.
        Inclusion Criteria:
        Patients must meet ALL of the following criteria to be eligible for participation in the
        study:
          -  *Patient is > 18 and < 90 years old
          -  *Clinical signs and symptoms consistent with acute submassive PE with duration ≤ 14
             days, as determined by the Investigator
          -  (*)CTA evidence of proximal PE (filling defect in at least one main or lobar pulmonary
             artery)
          -  (*)RV/LV ratio of ≥ 0.9 (Enrollment qualification assessment based on Investigator's
             interpretation of RV/LV ratio at baseline)
          -  *Systolic blood pressure ≥ 90 mmHg (initial SBP may be ≥ 80 mmHg if the pressure
             recovers to ≥ 90 mmHg with fluids)
          -  *Heart rate < 130 BPM prior to procedure
          -  *Patient is deemed medically eligible for interventional procedure(s), per
             investigator guidelines and clinical judgment
          -  Patient signs a written Informed Consent form to participate in the study, prior to
             any study mandated procedures
        Exclusion Criteria:
        Patients must be EXCLUDED from participation in this study if ANY of the following criteria
        are met:
          -  *Acute massive PE at presentation
          -  *Prior PE within last 6 months
          -  *Thrombolytic use within 30 days of baseline CTA
          -  *Pulmonary hypertension with peak pulmonary artery systolic pressure > 70 mmHg by
             right heart catheterization
          -  *Vasopressor requirement after fluids to keep pressure ≥ 90 mmHg
          -  *FiO2 requirement > 40% or > 6 LPM to keep oxygen saturation > 90%
          -  *Hematocrit < 28% (NOTE: hematocrit required within 24 hours of index procedure)
          -  *Platelets < 100,000/μL
          -  *Serum creatinine > 1.8 mg/dL
          -  *International normalized ratio (INR) > 3
          -  *aPTT (or PTT) > 50 seconds on no anticoagulation
          -  *Major trauma < 14 days
          -  *Presence of intracardiac lead in the right ventricle or right atrium placed within 6
             months
          -  *Cardiovascular or pulmonary surgery within last 7 days
          -  *Life expectancy less than 1 year due to advanced malignancy, as determined by the
             investigator at the time of enrollment
          -  *Known bleeding diathesis or coagulation disorder
          -  *Known left bundle branch block
          -  *History of severe pulmonary arterial hypertension
          -  *History of chronic left heart disease with left ventricular ejection fraction ≤ 30%
          -  *History of uncompensated heart failure
          -  *History of underlying lung disease that is oxygen dependent
          -  *Presence of IVC filter and or iliocaval stents
          -  *History of heparin-induced thrombocytopenia (HIT)
          -  *Any contraindication to systemic or therapeutic doses of heparin or anticoagulants
          -  *Known anaphylactic reaction to radiographic contrast agents that cannot be pretreated
          -  *Known allergy to any device component
          -  (*)Imaging evidence or other evidence that suggests, in the opinion of the
             Investigator, the Subject is not appropriate for mechanical thrombectomy intervention
             (e.g., inability to navigate to target location, predominately chronic clot or
             non-clot embolus)
          -  *Life expectancy of < 90 days, as determined by Investigator
          -  *Female who is pregnant or nursing
          -  *Current participation in another investigational drug or device treatment study