Utility of a Power Aspiration–Based Extraction Technique as an Initial and Secondary Approach in the Treatment of Peripheral Arterial Thromboembolism: Results of the Multicenter PRISM Trial

Saxon, Richard R.; Benenati, James F.; Teigen, Corey; Adams, George L.; Sewall, Luke E.; Trialists, Prism

doi:10.1016/j.jvir.2017.08.019

Cited by 34 publications

(27 citation statements)

References 17 publications

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“…The Penumbra system has previously been used for aspiration thrombectomy in the setting of cerebrovascular thrombi as well as peripheral arterial and venous emboli with good result. [14][15][16] This is the first report, to our knowledge, of its use in the heart itself. The currently available alternative to the Penumbra system for percutaneous removal of lead associated vegetation is the Angiovac system.…”

Section: Discussionmentioning

confidence: 79%

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Use of a clot aspiration system during transvenous lead extraction

Richardson

Lugo

Crossley

et al. 2020

Cardiovasc electrophysiol

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Introduction The optimal approach to the extraction of leads with large vegetations remains uncertain. Methods High‐risk patients with lead associated vegetations undergoing device extraction at Vanderbilt Hospital with concomitant use of the Penumbra Aspiration System (Penumbra Inc, Alameda, CA) are described. An 8.5 Fr Agilis NXT (Abbott Inc, St. Paul, MN) was advanced to the right atrium, through which a Penumbra Indigo Cat‐8 catheter was advanced. Using intracardiac echocardiography, the Penumbra was positioned directly on the vegetation, suction was applied until adherent, and the Indigo catheter and Agilis sheath were then removed en‐bloc and aspirated debris flushed out. This was repeated until debulking was considered successful. Results Eight cases were performed. The median vegetation size was 2 cm. Pathogens were Enterococcus, Staphylococcus, Candida, Cutibacterium, and Enterobacter. In seven of eight cases, aspiration successfully reduced vegetations to less than 1 cm before successful percutaneous cardiac implantable electronic device removal. One patient underwent surgical removal via thoracotomy. There were no acute complications related to the Penumbra catheter. Three patients had CT evidence of small pulmonary emboli postprocedure. The length of stay was 3 to 27 days. One patient died on POD 1 of refractory ventricular tachycardia unrelated to the procedure. One patient died of ongoing sepsis 2 weeks postextraction. Conclusions The Penumbra Indigo Aspiration system can be useful for vegetation debulking before transvenous lead extraction.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 88%

Use of a clot aspiration system during transvenous lead extraction

Richardson

Lugo

Crossley

et al. 2020

Cardiovasc electrophysiol

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“…8). 143 Use of adjunctive therapy should be anticipated (thrombolyisis, angioplasty with or without stent placement). A mismatch between the size of the catheter and arterial diameter is the main reason for not achieving complete clot removal.…”

Section: Other Endovascular Techniquesmentioning

confidence: 99%

“…effective after failed thrombolysis. 143,146 First line use of aspiration thrombectomy can reduce the need for CDT, without increasing costs. 141,147 3.6.2.…”

Section: Recommendation 32mentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Björck

Earnshaw

Acosta

et al. 2020

European Journal of Vascular and Endovascular Surgery

312

222

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“…Embolization risk may be offset with protection devices and is advisable in high-risk patients with single vessel runoff. 2,9,19,22,26 It is important to recall that endovascular thrombolysis or thromboembolectomy, at best, restores the vasculature to its baseline condition and the remaining thrombogenic lesion must be addressed in an endovascular (angioplasty or stent placement), open surgical, or hybrid technique to achieve a durable result.…”

Section: Endovascular Revascularizationmentioning

confidence: 99%

Acute Limb Ischemia Therapies: When and How to Treat Endovascularly

Hage

McDevitt

Vadlamudi

2018

Semin intervent Radiol

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Acute limb ischemia is an emergent limb and life-threatening condition with high morbidity and mortality. An understanding of the presentation, clinical evaluation, and initial workup, including noninvasive imaging evaluation, is critical to determine an appropriate management strategy. Modern series have shown endovascular revascularization for acute limb ischemia to be safe and effective with success rates approaching surgical series and with similar, or even decreased, perioperative morbidity and mortality. A thorough understanding of endovascular techniques, associated pharmacology, and perioperative care is paramount to the endovascular management of patients presenting with acute limb ischemia. This article discusses the diagnosis and strategies for endovascular treatment of acute limb ischemia.

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Utility of a Power Aspiration–Based Extraction Technique as an Initial and Secondary Approach in the Treatment of Peripheral Arterial Thromboembolism: Results of the Multicenter PRISM Trial

Cited by 34 publications

References 17 publications

Use of a clot aspiration system during transvenous lead extraction

Use of a clot aspiration system during transvenous lead extraction

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Acute Limb Ischemia Therapies: When and How to Treat Endovascularly

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