Bradyarrhythmias During Rheolytic Pharmacomechanical Thrombectomy for Deep Vein Thrombosis

Abstract

The occurrence of bradyarrhythmias during peripheral venous use of the AngioJet device is poorly described in the literature. Routine pre-treatment with various agents is not recommended during use of the device in peripheral venous beds as the incidence of bradyarrhythmias appears to be very low, with no defined mechanism of onset.

Efficacy and safety of catheter‐based rheolytic and aspiration thrombectomy in children

“…This, however, may relate to the smaller patient size in general in our series, which resulted in the AngioJet system being almost always close to the heart. However, even in adults, bradyarrhythmias and hypotension have been seen when used in the peripheral vasculature . Importantly, severe hemodynamic compromise was seen only in our initial experience when the AngioJet system was used for more than 5 sec at a time.…”

Pharmacomechanical Thrombolysis in the Management of Paget-Schroetter Syndrome

“…Firstly, although thrombolytic doses and the risk of haemorrhage are reduced, the overall safety of Trellis-8 in upper-limb PMT has not been formally evaluated in clinical trials. Additionally, concerns have been raised regarding the systemic effects of PMT, for example, the induction of bradyarrhythmias [14]. Furthermore, the cost advantages of Trellis-8 have only been proven in lower-limb DVT.…”

Intervention in Massive Pulmonary Embolus: Catheter Thrombectomy/Thromboaspiration versus Systemic Lysis versus Surgical Thrombectomy

“…It should be noted, however, that severe complications such as right ventricular free wall perforation 27 have been reported. 13 Rheolytic thrombectomy with the AngioJet (Boston Scientific) device uses the Bernoulli principle to break apart thrombus and has been used in the setting of massive PE; 25,28 however, procedural-related complications including bradyarrhythmias and deaths 29,30 have been reported using this device in the pulmonary arteries prompting the FDA to issue a black box warning. Mechanical thrombectomy may also be performed with a variety of other devices that include the Cleaner (Argon Medical Devices), Aspirex (Straub Medical), Helix Clot Buster (ev3), and FlowTriever (Inari Medical; ►Fig.…”