Emergent mechanical thrombectomy for right atrial clot and massive pulmonary embolism using flowtriever

Molano, Maria del Pilar Bayona; Salsamendi, Jason; Mani, N.

doi:10.1002/ccr3.3739

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…Right atrial thrombi formation can be precipitated in the presence of foreign bodies such as central venous access extending into the right atrium. The morphology and mobility potential of right atrial thrombi have been grouped into various types; A, B, and C [2]. The management involves evacuating the thrombus either surgically or with newer techniques involving percutaneous catheter-assisted thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

“…These commonly occur in patients with mechanical heart valves, ventricular or atrial septal closure devices, arrhythmias, indwelling central venous catheters, right-sided pacemaker leads or sequela of pulmonary embolism [1]. The incidence of RiHT is unclear; however, it occurs in about 10% of cases when associated with pulmonary thromboembolism [1,2]. Surgical thrombectomy has been considered the goal standard management modality for RiHT; though percutaneous embolectomy is an alternative treatment, but limited data support this approach [3].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Right Atrial Thrombectomy Using Flow Triever (Inari) and En Snare Endovascular System : A Safe Alternative to Surgical Approach - Report of Two Cases

Lewis¹,

Celestine²,

S³

et al. 2022

JCCI

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Surgical thrombectomy is considered the gold standard approach for removal of thrombotic disease within the right heart (RiTH), however some patients have prohibitive surgical risk and the percutaneous approach has been increasingly popular in the past few years. In this manuscript, we present two case reports of patients with both acute and chronic right atrial thrombi; in whom elevated surgical risk deemed them not surgical candidates and both successfully underwent mechanical thrombectomy with Flow Triever suction catheter and En snare endovascular system. To our knowledge, these are the first reported cases of the use of both of these devices for treatment of RiTH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Percutaneous Right Atrial Thrombectomy Using Flow Triever (Inari) and En Snare Endovascular System : A Safe Alternative to Surgical Approach - Report of Two Cases

Lewis¹,

Celestine²,

S³

et al. 2022

JCCI

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show abstract

“…On the other hand, Bayona M et al proposed that using FlowTriever would be better than using AngioVac due to no need for extracorporeal perfusion. It can be a preferred method for the treatment of CIT and PE, especially for people in whom thrombolysis is contraindicated [ 22 ].…”

Section: Reviewmentioning

confidence: 99%

A Proposed Approach for the Management of Clot-in-Transit

Patel¹,

Amrutiya²,

Manvar³

2022

Cureus

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Clot-in-transit (CIT) is defined as a mobile echogenic material in the right atrium or ventricle as observed on ultrasound. A right heart free-floating thrombus is unusual when there is no structural disease of the heart or atrial fibrillation. Cardiopulmonary collapse and quick death can come from CIT, which occurs when a blood clot moves from the heart to the lungs. There are some clinical case reports of a large volume thrombus that was freely floating in the right heart in an asymptomatic patient, and the best therapeutic options are uncertain. Although several trials have been conducted on the treatment of CIT, clinical judgment is still used to determine the best treatment for right heart thrombus (RHT), especially when associated with pulmonary embolism (PE). In this review article, we discuss various diagnostic modalities and treatment options for this rare malady. We studied in detail their clinical impact on patients according to past research studies.

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“…31 In addition to the device trials in PE, there are several retrospective studies and case reports of the use of the FlowTriever device for successful thrombus debulking in large venous beds for caval, portomesenteric, and RHT removal. [32][33][34][35]…”

Section: Flowtrievermentioning

confidence: 99%

Right Heart Clot-in-Transit: Endovascular Therapies

Mathevosian

Ranade

2022

Semin intervent Radiol

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Right heart thrombus is a challenging high mortality disease typically seen in the setting of pulmonary embolism. Traditional treatments have included anticoagulation, thrombolysis, and surgical embolectomy. Advances in recognition and treatment of clot-in-transit have led to the development of endovascular therapies increasingly becoming the preferred method of treatment due to rapid debulking and lower morbidity. Novel endovascular devices are large bore aspiration thrombectomy systems which mitigate the use of concomitant thrombolytics. The article reviews the disease process, relevant literature, and current endovascular devices and strategies for the treatment of right heart thrombus and clot-in-transit.

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Emergent mechanical thrombectomy for right atrial clot and massive pulmonary embolism using flowtriever

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 12 publications

References 21 publications

Percutaneous Right Atrial Thrombectomy Using Flow Triever (Inari) and En Snare Endovascular System : A Safe Alternative to Surgical Approach - Report of Two Cases

Percutaneous Right Atrial Thrombectomy Using Flow Triever (Inari) and En Snare Endovascular System : A Safe Alternative to Surgical Approach - Report of Two Cases

A Proposed Approach for the Management of Clot-in-Transit

Right Heart Clot-in-Transit: Endovascular Therapies

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