Venous Thromboembolic Disease: The Use of the Aspiration Thrombectomy Device AngioVac

Behrens, George; Bjarnason, Haraldur

doi:10.1055/s-0035-1564792

Cited by 32 publications

(15 citation statements)

References 13 publications

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“…IVC thrombus, although rare, are prevalent in the United States due to presumed overutilization of IVC filter and low rates of retrieval of filters [ 4 ]. Other complications of an IVC thrombus are post thrombotic syndrome, claudication, pulmonary embolism, renal vein thrombus and phlegmasia cerula dolens [ 5 , 6 , 8 ]. Some patients, as in this case, progress becoming unstable and are in need of therapeutic intervention.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most common modalities of therapeutic intervention with extensive thrombi is the AngioVac system. AngioVac system is used to remove undesirable intravascular material within the right ventricle, Superior Vena Cava (SVC), Inferior Vena Cava (IVC) and iliofemoral vessels [ 8 ]. The AngioVac system acts as an extracorporeal bypass circuit which creates a one-way suction flow to extract the unwanted material out of the vessel [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Successful IVC thrombus extraction with the AngioVac device following five vessel coronary artery bypass graft: a case report

Neubauer

Gianfrate

Henn

2021

J Cardiothorac Surg

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Background Inferior vena cava thrombosis is cited to be a complication of inferior vena cava filter placement and post coronary artery bypass surgery. Often only mild symptoms arise from these thrombi; however, due to the chronic nature of some thrombi and the recanalization process, more serious complications can arise. Although anticoagulation remains the gold standard of treatment, some patients are unable to be anticoagulated. In this case, we present a 65-year-old male who underwent IVC filter placement and open-heart surgery who later developed extensive femoral and iliocaval thrombosis leading to right heart failure, which required thrombus extraction with an AngioVac suction device. Case presentation We present a 65-year-old male who presented with bilateral pulmonary emboli with extensive right lower extremity deep vein thrombosis. Upon investigation he had ischemic heart disease and underwent a five-vessel coronary artery bypass for which he had an IVC filter placed preoperatively. On post operative day 3 to 4, he was decompensated and was diagnosed with an IVC thrombus. He progressed to right heart failure and worsening cardiogenic shock despite therapeutic anticoagulation and was taken for a suction thrombectomy using the AngioVac (AngioDynamics, Latham, NY) aspiration thrombectomy device. The thrombectomy was successful and he was able to recover and was discharged from the hospital. Conclusion Despite being a rare complication, IVC thrombosis can have detrimental effects. This case is an example of how IVC thrombus in the post-operative setting can lead to mortality. The gold standard is therapeutic anticoagulation but despite that, this patient continued to have worsening cardiogenic shock. Other therapies have been described but because of its rarity, they are only described in case reports. This case shows that the AngioVac device is a successful treatment option for IVC thrombus and can have the possibility of future use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful IVC thrombus extraction with the AngioVac device following five vessel coronary artery bypass graft: a case report

Neubauer

Gianfrate

Henn

2021

J Cardiothorac Surg

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“…The AngioVac® system (Angiodynamics Inc., Latham, NY, USA) utilizes a 22-French catheter to remove emboli. This device has seen very limited use in PE treatment because its large caliber makes it difficult to reach the pulmonary arteries [7]. The Penumbra Indigo system (Figure 4), as used in our case, utilizes a smaller caliber 8-French catheter for clot removal.…”

Section: Discussionmentioning

confidence: 99%

Catheter-Directed Thrombectomy for Pulmonary Embolism in the Setting of Acute Stroke

Hoster

Herring

Planek

et al. 2020

Cureus

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A 79-year-old male presented with an acute stroke and was treated with tissue plasminogen activator (tPA). His neurological symptoms improved, but he subsequently developed hemodynamic instability requiring intubation and vasopressors. Imaging studies revealed a massive pulmonary embolism as the cause of his worsening clinical picture. Mechanical thrombectomy using traditional devices was deemed too risky as the patient could not safely tolerate the usual anticoagulation dosage these devices require. The Penumbra Indigo® system (Alameda, CA, USA) was thus chosen for its ability to achieve thrombus aspiration within a lower therapeutic heparin range. Pulmonary artery aspiration thrombectomy was done using the device, and three days after the procedure, he was extubated and weaned completely off vasopressors. The therapy's efficacy despite the patient's unique life-threatening conditions demonstrates a novel application of the state-of-the-art pulmonary embolism treatment currently in research.

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“…The AngioVac venous drainage system, invented in 2012, was developed for the removal of fresh, soft thrombi or emboli from the vascular system. It was intended to be used as an alternative to anticoagulation, catheter-directed thrombolysis, mechanical thrombectomy, pharmacomechanical thrombectomy, or open surgical embolectomy [5, 6]. In a single-center analysis of 16 procedures, AngioVac aspiration achieved the removal of more than 70% of thrombi/masses with 67% and 100% success rate for the right atrial and iliocaval sites, respectively [7].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Aspiration of a Mobile Infected Thrombus from the Right Ventricular Outflow Tract Using the AngioVac System

Ugwu

Hussein

Alliu

et al. 2019

Case Reports in Cardiology

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The AngioVac system was invented in 2012 and was originally designed for the removal of thrombi from the venous system. It has been successfully used in the management of iliocaval and right endocardial thrombi but is reportedly less effective in the management of pulmonary emboli (PE). Since its advent, there has been interest in its application towards other medical situations. One of the most revolutionary uses thus far has been for percutaneous debridement of valvular and cardiac electronic device-associated vegetations. In most instances, the AngioVac device has been used to obviate the need for surgery in high-risk patients. Here, we describe a novel use of this device in the successful retrieval of a large, mobile, infected thrombus from the right ventricular outflow tract in a high surgical-risk patient.

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Venous Thromboembolic Disease: The Use of the Aspiration Thrombectomy Device AngioVac

Cited by 32 publications

References 13 publications

Successful IVC thrombus extraction with the AngioVac device following five vessel coronary artery bypass graft: a case report

Successful IVC thrombus extraction with the AngioVac device following five vessel coronary artery bypass graft: a case report

Catheter-Directed Thrombectomy for Pulmonary Embolism in the Setting of Acute Stroke

Percutaneous Aspiration of a Mobile Infected Thrombus from the Right Ventricular Outflow Tract Using the AngioVac System

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