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Utilization of AngioVac and snare for eradication of a mobile right atrial thrombus

Joshua C Grimm1, Anahita M Parsee1, Jeffrey A Brinker2

  • 1Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, Maryland.

The Annals of Thoracic Surgery
|February 3, 2015
PubMed

Insights

Central venous catheters can increase the risk of right atrial thrombus. A novel approach using the AngioVac Aspiration System and snare catheterization successfully removed a complex thrombus unresponsive to medical therapy.

Area of Science:

  • Cardiology
  • Interventional Radiology

Background:

  • Right atrial thrombus formation is associated with central venous catheter use.
  • Management strategies depend on clot characteristics and patient factors.
  • Thrombolytic therapy may be insufficient for chronic or adherent thrombi, posing embolic risks.

Observation:

  • A patient presented with a right atrial thrombus.
  • The thrombus was deemed unsuitable for conventional thrombolytic therapy due to chronicity and adherence.
  • This posed a significant risk of embolic events.

Findings:

  • A combined approach utilizing the AngioVac Aspiration System and percutaneous snare catheterization was employed.
  • This minimally invasive technique successfully removed the complex right atrial thrombus.
  • Complete clot burden resolution was achieved without immediate embolic complications.

Implications:

  • This case highlights a viable alternative for managing complex right atrial thrombi unresponsive to medical treatment.
  • The AngioVac system offers a promising option for interventional cardiologists and radiologists.
  • This approach may reduce the risk of embolic events in challenging thrombus cases.

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