Single-Center Experience Using AngioVac with Extracorporeal Bypass for Mechanical Thrombectomy of Atrial and Central Vein Thrombi

Resnick, Scott A.; O’Brien, Dan; Strain, David; Malaisrie, Chris; Schimmel, Daniel; Salem, Riad; Vogelzang, Robert L.

doi:10.1016/j.jvir.2016.02.009

Cited by 37 publications

(31 citation statements)

References 15 publications

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“…The majority of studies report the use of the AngioVac device in a controlled operating room setting. 46,49 Similarly, in our experience we have found that a hybrid operating room suite serves as an ideal setting for performing AngioVac suction thrombectomy. This not only provides access to state-of-theart fluoroscopy-based imaging capabilities and an array of catheter-based devices, but also affords an environment that facilitates swift dealing with unforeseen bleeding, vessel injury, or a rare need for open surgical conversion.…”

Section: Coordination Of Resourcesmentioning

confidence: 83%

“…Recent reports demonstrate that the majority of IJ and femoral cannulations for extracorporeal circulation can be achieved via percutaneous access. 46,50,51 However, similar to other reports, we have evolved to perform all IJ cannulations through a small oblique cut-down incision with exposure of the proximal IJ. 45 Compared with large-diameter percutaneous cannulation of the IJ, the cut-down approach facilitates adequate intraoperative mobilization of the sternocleidomastoid muscle (which provides the majority of resistance encountered during advancement of large-diameter sheaths through the IJ cannulation) and allows for a more reliable placement of a 26F sheath in which the AngioVac cannula can be advanced through.…”

Section: Technical Strategiesmentioning

confidence: 90%

“…The AngioVac device (AngioDynamics, Inc., Queensbury, NY) is an Food and Drug Administration (FDA)-approved large-diameter (22F) suction device platform that is suggested as an alternative thrombectomy device for the treatment of large volume cavoatrial DVTs. [45][46][47] The AngioVac system is reported to reliably remove large volume thrombi from the right atrium, 48 SVC, 45 suprarenal and infrarenal IVC, and iliac venous systems. 46 The device uses a vacuumassisted, Nitinol reinforced, suction cannula that is attached to an extracorporeal veno-venous circuit.…”

Section: Overview Of Management Strategymentioning

confidence: 99%

“…[45][46][47] The AngioVac system is reported to reliably remove large volume thrombi from the right atrium, 48 SVC, 45 suprarenal and infrarenal IVC, and iliac venous systems. 46 The device uses a vacuumassisted, Nitinol reinforced, suction cannula that is attached to an extracorporeal veno-venous circuit. The circuit is spliced by a filter apparatus that removes thrombi from the venous aspirate prior to recirculation into a venous inflow cannula inserted elsewhere in the central venous system.…”

Section: Overview Of Management Strategymentioning

confidence: 99%

“…In the presence of a cardiovascular anesthesiologist, the procedure can also be performed under general anesthesia and constant perioperative hemodynamic monitoring. 46,[48][49][50] A peripheral arterial line, and an adjunct central intravenous access, is a useful adjunct to have during the procedure. Access to intraoperative transesophageal echocardiogram (TTE) can be very valuable for evaluating intraoperative gross heart function during periods of veno-venous extracorporeal circulation.…”

Section: Coordination Of Resourcesmentioning

confidence: 99%

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Management of Cavoatrial Deep Venous Thrombosis: Incorporating New Strategies

Zayed

Silva

Ramaswamy

et al. 2017

Semin intervent Radiol

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Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years. Each therapeutic modality requires operator expertise and a coordinated care paradigm to facilitate successful outcomes. Open surgical thrombectomy is alternatively reserved for specific patient conditions, including intolerance of anticoagulation, failed catheter-based interventions, or acute emergencies.

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Section: Coordination Of Resourcesmentioning

confidence: 83%

Section: Technical Strategiesmentioning

confidence: 90%

Section: Overview Of Management Strategymentioning

confidence: 99%

Section: Overview Of Management Strategymentioning

confidence: 99%

Section: Coordination Of Resourcesmentioning

confidence: 99%

See 3 more Smart Citations

Management of Cavoatrial Deep Venous Thrombosis: Incorporating New Strategies

Zayed

Silva

Ramaswamy

et al. 2017

Semin intervent Radiol

View full text Add to dashboard Cite

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Effectiveness of the vacuum assisted aspiration AngioVac system in the removal of intravascular masses

Nickell

Sergev

Alberto

et al. 2023

Cathet Cardio Intervent

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Background: Invasive procedures used to manage intravascular masses such as vegetation from endocarditis, deep vein thrombosis, and septic emboli are associated with high rates of complications and mortality, especially in patients with several pre-existing comorbidities. A minimally invasive technique that has become more popular in recent years is the AngioVac procedure. This singlecentered, retrospective study focuses on patient presenting comorbidities and indications for the procedure as well as postprocedural outcomes.Methods: A total of 33 patients who underwent an AngioVac procedure at Sanford Health between March 2014 and October 2019 was reviewed. Data were collected on pre-existing comorbidities, indication of procedure, length of stay, and postoperative outcomes.Results: We evaluated a total of 33 patients who underwent an AngioVac procedure for removal of intravascular mass. The most common indications for the procedure were endocarditis (24/33, 73%); intracardiac mass (5/33, 15%); and deep vein thrombosis or pulmonary embolism (2/33, 6%). Post-procedural blood transfusion was required in nearly half (15/33, 45%). Almost all patients (31/33, 94%) required intraoperative vasopressor use. Nearly all patients (32/33, 97%) were directed to the intensive care unit following the procedure with an average length of stay of 8 days (interquartile range: 3−13). Most common complications seen after the procedure were shock requiring vasopressors, (13/33, 39%), pleural effusion (9/33, 27%), and sepsis (4/33, 12%). Procedural success in this single-centered experience was 85% (28/33), which was defined as size reduction of the initial vegetation by >50% in the absence of severe intraoperative complications and absence of need for further valvular surgical intervention. Conclusion:For surgically high-risk patients, the AngioVac procedure may offer a less invasive option in the management of right sided endocarditis requiring vegetation debulking, intravascular thrombi or cardiac masses.

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