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Percutaneous thrombectomy using a novel single-session device for acute ilio-caval deep vein thrombosis
Jason R Crowner1, William Marston1
1Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC.
Summary
A patient experienced leg swelling after spinal fusion due to a blood clot. Mechanical thrombectomy successfully removed the clot, resolving symptoms and demonstrating a safe, effective treatment for deep vein thrombosis post-surgery.
Area of Science:
- Vascular Surgery
- Neurosurgery
- Interventional Radiology
Background:
- Lumbar interbody fusion can lead to complications such as deep vein thrombosis (DVT).
- External compression of the common iliac vein by extruded bone graft material is a rare but serious complication.
- Acute leg pain and edema are primary symptoms of DVT.
Observation:
- A 53-year-old male presented with acute left leg pain and edema two weeks post-lumbar interbody fusion.
- Computed tomography venogram revealed extensive acute thrombosis from the calf to the common iliac vein.
- The thrombosis was attributed to external compression of the common iliac vein by extruded bone graft material.
Findings:
- Endovascular intervention using a novel percutaneous mechanical thrombectomy system (ClotTriever) was performed.
- The procedure successfully removed the clot in a single session without thrombolysis.
- Venous stenting was performed, leading to symptom resolution and minimal residual swelling at six months.
Implications:
- Percutaneous mechanical thrombectomy offers a safe and effective alternative for treating DVT secondary to spinal surgery complications.
- This approach avoids the risks associated with thrombolysis in certain patient populations.
- Successful clot removal and stenting can restore venous outflow and improve patient outcomes after complex spinal procedures.
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