Percutaneous Large Thrombus and Vegetation Evacuation in the Catheterization Laboratory

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Intracardiac and intravascular thrombi pose significant health risks, leading to high morbidity and mortality.
• Surgical intervention, the traditional treatment, is often complicated by patient comorbidities.
• Advancements in catheter-based techniques are introducing less invasive therapeutic options.

Purpose of the Study:

• To review the application and efficacy of the AngioVac device for percutaneous removal of intravascular and intracardiac thrombi.
• To highlight the AngioVac's role as an alternative in complex patient populations.

Main Methods:

• The AngioVac is a Food and Drug Administration (FDA)-approved, percutaneous, vacuum-assisted thrombectomy device.
• It operates within a venovenous extracorporeal membranous oxygenation circuit, incorporating a filtration system.
• Case reports and existing literature on AngioVac utilization were reviewed.

Main Results:

• The AngioVac has demonstrated utility in removing right atrial and iliocaval thrombi.
• It has been successfully used for debulking tricuspid valve vegetations and removing vegetations from cardiac implantable devices.
• Applications also extend to managing pulmonary embolism.

Conclusions:

• The AngioVac represents a viable percutaneous option for managing challenging intracardiac and intravascular thrombi.
• Its use expands treatment possibilities for patients with contraindications to traditional surgery.
• Further research may solidify its role in various thrombotic and embolic conditions.