Right heart thrombus and pulmonary embolism is a condition that requires emergent treatment with reported fatal outcomes. Endovascular mechanical thrombectomy of right heart clot has been described with the use of AngioVac. We describe the use of FlowTriever device as a feasible alternative to treat clot in transit.

The association of right heart thrombus (RiHT) and massive pulmonary embolism (PE) has an incidence of 4-18%. It is a life-threatening condition that requires emergent diagnosis and treatment with reported fatal outcomes up to 21% in 14 days. Endovascular mechanical thrombectomy of right heart clot has been described focused on the use of AngioVac (AngioDynamics, Latham, NY, USA), however, a recent report supported the safety of image guided FlowTriever(Inari Medical Inc., Irvine, CA, USA). Our case report describes the use of FlowTriever device as a unique modality to treat clot in transit and massive PE when thrombolysis is contraindicated.