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Related Experiment Video

Updated: Sep 16, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Visceral aortic thrombectomy using endovascular technique.

Vy C Dang1, Shrishiv A Timbalia2, Maham Rahimi2

  • 1Texas A&M University College of Medicine, Bryan, TX.

Journal of Vascular Surgery Cases and Innovative Techniques
|July 11, 2025
PubMed
Summary
This summary is machine-generated.

This case study details the successful off-label use of a specific sheath during mechanical aortic thrombectomy for acute visceral artery occlusion in a patient on extracorporeal membrane oxygenation, resolving severe lactic acidosis.

Keywords:
Aortic thrombusEndovascularVisceral aortic thrombectomy

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Cardiogenic shock and visceral artery occlusion present complex management challenges.
  • Extracorporeal membrane oxygenation (ECMO) and left ventricular assist devices (LVADs) are critical support in severe cases.
  • Acute aortic and visceral artery thrombosis can lead to multi-organ failure.

Observation:

  • A 58-year-old male on ECMO and LVAD experienced worsening lactic acidosis due to acute occlusion of the visceral aorta, celiac axis, SMA, and left renal artery.
  • The patient could not tolerate aortic cross-clamping, necessitating an alternative thrombectomy approach.
  • Off-label use of the Inari ProTrieve Sheath was employed for mechanical aortic thrombectomy.

Findings:

  • Mechanical aortic thrombectomy using the ProTrieve Sheath prevented distal thromboembolic events.
  • Subsequent retrograde SMA thrombectomy and patch angioplasty restored visceral artery patency.
  • The patient demonstrated significant improvement in lactic acidosis post-procedure.

Implications:

  • This approach offers a viable alternative for aortic thrombectomy in high-risk patients on ECMO.
  • Off-label use of specific devices can expand treatment options for complex vascular emergencies.
  • Successful management improved patient outcomes and organ perfusion.