Pulmonary embolism (PE) is most often a result of deep vein thrombosis (DVT), and rarely occur due to a non-thrombotic source. In this case, a 79-year-old man with known metastatic renal cell carcinoma (RCC), end-stage kidney disease (ESKD) on hemodialysis and a history of 6 hours of car travel presented to the hospital with shortness of breath, weakness, syncopal episodes, and an initial SpO2 of 85% on room air. After positive chest radiographic findings of pulmonary congestion, a subsequent computed tomography angiogram confirmed a large embolus near totally occluding the right main pulmonary artery. Given the RCC and the abnormal presentation of PE, endovascular mechanical embolectomy was performed using the FlowTriever System (Inari Medical). Pulmonary artery patency was restored, and the pressure improved immediately following embolus aspiration. Pathological findings confirmed renal cell carcinoma as the constituent of the embolus. The Inari FlowTriever system can be used to successfully aspirate RCC emboli present in the large pulmonary arteries.

Keywords: Case report; Pulmonary embolism; Renal cell carcinoma; Mechanical embolectomy; Inari; FlowTriever