Large Solid Right Atrial Thrombus Treated by AngioVac Catheter-Based Suction Thrombectomy.

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Large atrial thrombi pose significant risks, including pulmonary embolism.
• Anticoagulation alone may be insufficient for resolving large, solid atrial thrombi.
• Catheter-based interventions offer minimally invasive treatment options for complex thrombotic conditions.

Observation:

• A 60-year-old male presented with acute pulmonary embolism, deep vein thrombosis, and a large right atrial thrombus.
• One week of anticoagulation did not reduce the size of the atrial thrombus.
• The AngioVac® system was employed for catheter-directed suction embolectomy.

Findings:

• The solid atrial thrombus initially occluded the AngioVac® catheter during the procedure.
• Successful thrombus removal was achieved by maintaining vacuum and removing the occluded catheter.
• Repeat suction with the AngioVac® system cleared the remaining atrial thrombus.
• The patient recovered well and was discharged within 7 days post-procedure.

Implications:

• Catheter-based suction embolectomy using the AngioVac® system is a viable and safe treatment for large, solid right atrial thrombi.
• This minimally invasive approach can be effective when anticoagulation fails.
• The AngioVac® system demonstrates potential for managing complex intracardiac thrombi, reducing the need for open surgery.