Percutaneous Thrombectomy Using a Computer-Assisted Aspiration Device for Deep Vein Thrombosis

To demonstrate the safety and effectiveness of a computer-assisted large-bore thrombectomy (CA-LBT) device in aspiration thrombectomy for treatment of deep vein thrombosis (DVT).

A single-institution retrospective review was performed to include 16 consecutive patients (median age, 51.1 years; range, 19-77 years; 5 men and 11 women) who underwent percutaneous thrombectomy using a 16-F CA-LBT device (Lightning Flash Aspiration System; Penumbra, Alameda, California) for DVT (12 iliofemoral occlusions with or without caval extension [75.0%], 3 axillosubclavian occlusions [18.8%], and 1 caval occlusion [6.3%]) between January 2023 and August 2023.

Thrombectomy was performed via the popliteal (n = 10, 62.5%), femoral (n = 3, 18.8%), saphenous (n = 1, 6.3%), brachial (n = 1, 6.3%), and femoral and brachial (n = 1, 6.3%) veins, with a median fluoroscopy time of 17 minutes (range, 7.2-61 minutes) and contrast agent volume of 110 mL (range, 30-175 mL). Restoration of anterograde flow was achieved in all cases (100%, 16/16). Thirteen patients (81.2%) received venoplasty after thrombectomy for residual stenosis. Stents were placed in 7 patients (43.8%). With a median clinical follow-up of 77 days (range, 3-278 days), symptom improvement was achieved among 13 of 15 patients (86.7%) who initially presented with DVT-associated symptoms. Of 14 patients with imaging follow-up, patency was confirmed in 12 (85.7%). Of the 2 patients (14.3%) with complete thrombosis on follow-up imaging, one patient was successfully treated with repeated thrombectomy using CA-LBT technology and the other was treated with systemic anticoagulation.

Aspiration thrombectomy with this 16-F CA-LBT device is a feasible option for treatment of proximal or large-volume DVT.