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Comparison of aspiration thrombectomy to other endovascular therapies for proximal upper extremity deep venous

Tim Fuller1, Evan Neville1, Jacob Shapiro1

  • 1Department of Vascular Surgery, Good Samaritan Hospital & Bethesda North Hospital, Cincinnati, Ohio.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|August 26, 2021
PubMed

Insights

Aspiration thrombectomy (AT) achieved 100% technical success for acute upper extremity deep venous thrombosis (UEDVT). This method offers higher single-session treatment rates, potentially reducing bleeding risks compared to other techniques.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Management

Background:

  • Deep venous thrombosis (DVT) can cause significant morbidity.
  • Catheter-directed thrombolysis (CDT) is effective but carries hemorrhagic risks.
  • Acute upper extremity DVT (UEDVT) secondary to venous thoracic outlet syndrome presents unique challenges.

Purpose of the Study:

  • To evaluate the technical success of endovascular therapies for acute UEDVT.
  • To compare a new mechanical aspiration thrombectomy (AT) device with non-aspiration thrombectomy (NAT) techniques.
  • To assess the rate of single-session therapy and thrombus resolution.

Main Methods:

  • Single-center retrospective review of 22 patients with acute symptomatic proximal UEDVT.
  • Patients underwent endovascular therapy including AT, CDT, ultrasound-assisted thrombolysis (USAT), and rheolytic thrombectomy.
  • Outcomes were compared between AT and NAT groups, focusing on technical success (>70% thrombus resolution) and single-session treatment.

Main Results:

  • 100% technical success rate for all endovascular therapies (22/22 patients).
  • Aspiration thrombectomy (AT) group showed 50% single-session therapy rate (5/10), compared to 8.3% in the non-aspiration thrombectomy (NAT) group (1/12).
  • AT group used a lower average dose of thrombolytics (12.6 mg vs. 19.0 mg).

Conclusions:

  • Aspiration thrombectomy (AT) demonstrates high technical success for acute UEDVT.
  • AT facilitates higher rates of single-session treatment, potentially mitigating bleeding complications.
  • Further research is warranted to establish AT's role in UEDVT management.
Abstract

Keywords:
Aspiration thrombectomyCatheter-directed thrombolysisUpper extremity deep venous thrombosisVenous thromboembolism

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