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Percutaneous thrombectomy of upper extremity and thoracic central veins using Inari ClotTriever System: Experience in

Ashley M Sweeney1, Mina S Makary1, Colvin Greenberg2

  • 1Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH.

Journal of Vascular Surgery Cases and Innovative Techniques
|February 28, 2023
PubMed

Insights

Percutaneous thrombectomy using the ClotTriever system effectively treated deep venous occlusive disease in upper extremity and thoracic veins. This minimally invasive procedure achieved excellent technical and clinical success, resolving patient symptoms without major adverse events.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Deep venous occlusive disease in the upper extremity and thoracic central veins can cause significant morbidity.
  • Malignancy, infection, and benign etiologies can lead to thrombus formation in these critical venous structures.
  • Traditional treatments may have limitations, necessitating advanced minimally invasive options.

Purpose of the Study:

  • To evaluate the technical and clinical outcomes of percutaneous thrombectomy using the ClotTriever system for deep venous occlusive disease in the upper extremity and thorax.
  • To assess the feasibility and safety of the ClotTriever system in this patient population.

Main Methods:

  • A retrospective review of 14 patients who underwent thrombectomy with the ClotTriever system between October 2020 and January 2022.
  • Data collected included technical success, adverse events, imaging follow-up, and clinical outcomes.
  • Patients presented with symptomatic venous occlusive disease due to malignancy, infection, or benign causes.

Main Results:

  • Successful thrombectomy was achieved in all 14 patients.
  • The primary indications for treatment included malignancy-related DVT (64.3%), infected thrombi (14.3%), and benign etiologies (21.4%).
  • All patients experienced symptom resolution, with 50% requiring additional venous stent reconstruction; no major adverse events were reported.

Conclusions:

  • Percutaneous thrombectomy with the ClotTriever system is a feasible and effective treatment for symptomatic deep venous occlusive disease in the upper extremity and thoracic veins.
  • The procedure demonstrates excellent technical and clinical success rates with a favorable safety profile.
  • The ClotTriever system offers a valuable minimally invasive therapeutic option for complex venous occlusions.
Abstract

Keywords:
ClotTrieverSVC syndromeSuperior vena cava syndromeThoracic central venous occlusive diseaseUpper extremity DVT

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