Use of thrombectomy aspiration in the treatment of acute venous thrombosis

Abstract

Objectives: This paper presents new possibilities of treatment of acute thrombosis located in proximal segments of upper and lower limb veins using transcutaneous mechanical thrombectomy and transcatheter thrombolysis. Material and methods: The procedures were carried out in patients hospitalised in the Department of Vascular Surgery of the Provincial Hospital Complex in Kielce. Qualification for the procedure was based on the prevention and treatment guidelines for venous thromboembolism in Poland and worldwide. The treatments were performed using a Penumbra Indigo thrombectomy device. The observation covers the first half of 2017. Results: Out of 24 patients hospitalised in this period due to deep vein thrombosis, six had aspiration thrombectomy; the remaining patients were treated with the traditional method. In five patients a very good treatment effect was obtained and immediate regression of swelling and pain of the limb was observed. The applied treatment significantly shortened the hospitalisation time by half on average compared to traditional treatment and did not cause significant complications except minor bleeding. During the half-year follow-up period, patients undergoing treatment did not experience any recurrence of pain, swelling, or recent thrombosis. Conclusions: Aspiration thrombectomy combined in some cases with transcatheter thrombolysis allows rapid removal of thrombi and resection of veins and leads to quick relief of symptoms, at the same time reducing hospitalisation time and immobilisation at home. Given the novel nature of the device, further observation is needed to demonstrate the safety and comparable efficacy of this method, including randomised, controlled clinical trials before any recommendations for its use can be made.

Surgical Considerations in the Treatment of Axillary-Subclavian Venous Thrombosis in the Era of COVID-19

“…Suction thrombectomy using the Indigo system from Penumbra has shown excellent success when dealing with fresh thrombus in the arterial and venous systems, in both the peripheral and coronary vasculature. 5 The system consists of a disposable catheter, separator device and a vacuum pump which provides -29 mmHg suction. The catheters come in 4 different sizes of 3.4 F, 5.0 F, 6.0 F and 8.0 F. The CAT 8 suction catheter is large enough to remove substantial amounts of thrombus and the ability of the angulated atraumatic catheter tip to sweep against the wall of the vein enables a more complete thrombectomy.…”