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Related Experiment Video

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Percutaneous Vacuum-Assisted Thrombectomy Using AngioVac Aspiration System.

Furqan A Rajput1, Lianlian Du2, Michael Woods3

  • 1Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States of America.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|December 29, 2019
PubMed
Summary

Vacuum-assisted thrombectomy (VAT) using the AngioVac system offers a safe alternative for removing large blood clots when surgery or thrombolysis is too risky. This method effectively cleared clots with no procedure-related deaths in a case series.

Keywords:
AngioVacIntracardiac thrombiMechanical thrombectomyPercutaneous thrombectomyPulmonary embolism

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Area of Science:

  • Cardiology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Surgical embolectomy and thrombolytic therapy are standard treatments for large intra-cardiac or intravascular thrombi to prevent pulmonary embolism (PE).
  • These traditional methods carry significant risks, including high operative mortality for surgical embolectomy and increased bleeding risk for thrombolytic therapy.
  • Percutaneous aspiration thrombectomy, specifically using the AngioVac aspiration system, presents a viable alternative for patients unsuitable for conventional treatments.

Purpose of the Study:

  • To evaluate the efficacy and safety of the AngioVac aspiration system for evacuating large caval thrombi or intracardiac masses.
  • To describe the clinical outcomes of patients undergoing AngioVac-based thrombectomy.

Main Methods:

  • A retrospective analysis was conducted on 16 consecutive patients treated with the AngioVac catheter between January 2016 and January 2019.
  • Data collected included patient characteristics, indications for the procedure, and in-hospital clinical outcomes.

Main Results:

  • Sixteen patients (mean age 48) underwent 16 AngioVac procedures. Indications included intracardiac mass (68.8%), caval thrombus (56.3%), and catheter-associated thrombus (43.8%).
  • Concurrent pulmonary embolism (PE) was present in 7 (43.8%) patients. Peri-procedure mortality was 0%, with an in-hospital mortality of 12.5% at a mean follow-up of 14 days.
  • No pulmonary hemorrhages, strokes, or myocardial infarctions occurred. While 62.5% experienced a drop in hemoglobin requiring transfusion, no overt bleeding episodes were reported.

Conclusions:

  • The AngioVac aspiration system demonstrates effectiveness in aspirating large volumes of intravascular and intracardiac thrombus.
  • It serves as a reasonable alternative to surgical thrombectomy for patients with large central thrombi or masses at risk of complicated PE.