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The AngioVac Device: Understanding the Failures on the Road to Success

Berhane Worku1, Arash Salemi, Marcus D DʼAyala

  • 1From the *Department of Cardiothoracic Surgery, New York Methodist Hospital, Brooklyn, NY USA; †Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York Presbyterian Hospital, New York, NY USA; and ‡Division of Vascular Surgery, New York Methodist Hospital, Brooklyn, NY USA.

Innovations (Philadelphia, Pa.)
|November 24, 2016
PubMed

Insights

The AngioVac device effectively removes intact thrombus from the iliac, caval, and heart regions, offering a successful alternative to surgery. However, its efficacy is lower for pulmonary emboli, necessitating careful patient selection for optimal outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Devices

Background:

  • Percutaneous thromboembolectomy often requires thrombus fragmentation and thrombolysis, increasing risks of bleeding and thromboembolic complications.
  • The AngioVac device provides a percutaneous venovenous bypass to aspirate intact thrombus, potentially mitigating these risks.

Purpose of the Study:

  • To review the literature on the AngioVac device.
  • To identify factors correlating with successful thrombus extraction using the AngioVac system.

Main Methods:

  • A literature search was conducted using the PubMed database for studies on the AngioVac device.
  • Twenty-three reports detailing 57 procedures in 56 patients were analyzed.

Main Results:

  • Complete thrombus removal was achieved in 75% of cases.
  • Success rates were high for iliocaval thrombus (87%) and right heart thrombus (82%).
  • Pulmonary emboli showed a significantly lower success rate (12.5%), with overall complications occurring in 12% of procedures.

Conclusions:

  • The AngioVac device is a viable alternative to surgical thrombectomy for iliocaval and intracardiac thrombus.
  • Patient selection is crucial for improving outcomes, particularly as pulmonary emboli appear less amenable to this technique.
  • Further research with larger patient cohorts is needed to solidify these findings.
Abstract

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