Use of the Protrieve sheath to trap embolizing thrombus during a complex mechanical thrombectomy procedure with a thrombosed inferior vena cava filter

Intraprocedural Use of the Novel Protrieve Sheath Removes Embolus During Mechanical Thrombectomy of a Complex Iliocaval Deep Vein Thrombosis

“…In these reports, procedurally generated emboli were trapped and removed via large-bore aspiration through the Protrieve sheath. 6,14 Though anecdotal, the experiences described here and in prior publications indicate that the sheath may provide a safe approach to minimizing the risk of complications during mechanical thrombectomy of complex DVT. Nonetheless, the total number of patients described in the peer-reviewed literature whose treatment included use of the Protrieve sheath is currently only 4, including the current report.…”

“…[1][2][3][4] Still, the chance for adverse events is heightened in cases of complex DVT. 6 The ClotTriever catheter is designed for use in veins with a maximum diameter of 16 mm, smaller than the IVC diameter of many adult patients. 12,13 Consequently, IVC thrombus may escape the collection bag during thrombectomy and embolize.…”

“…Nonetheless, the total number of patients described in the peer-reviewed literature whose treatment included use of the Protrieve sheath is currently only 4, including the current report. 6,14 Clinical studies will be necessary to confirm that the sheath is safe and indeed decreases the incidence of adverse events in such cases. If, with additional research, it can be determined that its use improves the risk-to-benefit calculation for intervention, the unique features of the sheath might increase the population of patients with proximal and central thrombus who receive advanced therapies.…”

“…[1][2][3][4] However, the risk of potentially life-threatening thrombus embolization remains when treating complex DVT, 5 which includes cases of inferior vena cava (IVC) thrombosis. 6 The central location of IVC thrombus makes it particularly susceptible to mobilization during thrombectomy procedures. 5 The Protrieve sheath (Inari Medical, Irvine, California) is a new device designed to enhance the safety of complex DVT interventions.…”

“…1-4 However, the risk of potentially life-threatening thrombus embolization remains when treating complex DVT, 5 which includes cases of inferior vena cava (IVC) thrombosis. 6 The central location of IVC thrombus makes it particularly susceptible to mobilization during thrombectomy procedures. 5…”