Aspiration mechanical thrombectomy for treatment of acute iliofemoral and central deep venous thrombosis

Utility of a percutaneous mechanical thrombectomy device in retrieval of an iatrogenic intravascular foreign body

“… 3 , 6 It has an expandable nitinol coring element that provides wall-to-wall apposition. 4 , 5 In our patient, this coring element was able to engage and retrieve the chronically retained IVFB, in addition to the thrombus. The second element of the Inari ClotTriever system, in continuity with the coring element, is an integrated nitinol collection bag ( Fig 6 ).…”

“…The Inari ClotTriever thrombectomy system was developed for use in the venous system for thrombus removal in a single setting. 3,6 It has an expandable nitinol coring element that provides wall-to-wall apposition 4,5 . In our patient, this coring element was able to engage and retrieve the chronically retained IVFB in addition to the thrombus.…”

“… 4 , 6 Minimal blood loss occurs with the use of this thrombectomy system. 5 However, the principle disadvantage is the potential entanglement of its two elements (the coring element and the collection bag) with the tines of a preexisting inferior vena cava (IVC) filter or the struts of venous stents, especially Gianturco Zenith stents (Cook Medical Inc, Bloomington, IN). 5 , 6 To prevent such problems, three potential solutions exist.…”

“… 5 However, the principle disadvantage is the potential entanglement of its two elements (the coring element and the collection bag) with the tines of a preexisting inferior vena cava (IVC) filter or the struts of venous stents, especially Gianturco Zenith stents (Cook Medical Inc, Bloomington, IN). 5 , 6 To prevent such problems, three potential solutions exist. One is to start the thrombectomy below the level of the IVC filter or Zenith stent.…”

“… 2 , 3 , 4 Thrombolytic agents will generally not be required with the use of ClotTriever system and patients will not require monitoring in the intensive care unit afterward. 3 , 5 More recently, our center has shown the utility of the ClotTriever system in the treatment of calcified in-stent restenosis in the iliofemoral venous system. 6 In the present report, we have described the case of a patient with a symptomatic left innominate vein DVT who also had had a retained catheter fragment from a tunneled infusion catheter in the left innominate vein.…”