Provisional Review and Comparison of ClotTreiver Mechanical Thrombectomy Versus Catheter Directed and Other Mechanical Thrombolysis and Thrombectomy Modalities for Lower Extremity Deep Venous Thrombosis

Objective This study was performed to evaluate the efficacy and feasibility of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in patients with acute pulmonary embolism (APE) and lower extremity deep venous thrombosis (LEDVT). Methods In total, 20 consecutive patients with APE and LEDVT were prospectively selected for PMT combined with CDT. Mechanical thrombus fragmentation and aspiration using a pigtail rotation catheter followed by CDT was performed in each patient. Details regarding the patients’ clinical presentation and outcome, pulmonary status parameters (pulmonary arterial pressure, partial pressure of oxygen in arterial blood, Miller score, thigh and calf circumference, and shock index), and lower extremity parameters (thrombus-lysis grade and Villalta scale score) were recorded. Results All 20 patients’ clinical manifestations significantly improved. Both the clinical success rate and technical success rate were 100%. No major adverse events occurred during hospitalization. Four patients developed iliac vein compression syndrome and underwent stent implantation in the iliac vein. No pulmonary embolism recurred within 16.5±6.8 months of follow-up. Conclusions The combination of PMT and CDT is a safe and effective treatment for APE and LEDVT with good short- and intermediate-term clinical outcomes.

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Dual and Balloon-Assisted AngioJet Thrombectomy for Iliofemoral Deep Venous Thrombosis

10.1093/med/9780199986071.003.0038 ◽

2018 ◽

Author(s):

Zubin Irani ◽

Sara Zhao

Keyword(s):

Pulmonary Embolism ◽

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Mechanical Thrombectomy ◽

Post Thrombotic Syndrome ◽

Thrombus Removal ◽

Phlegmasia Cerulea Dolens ◽

Extremity Veins

Lower extremity deep venous thrombosis (DVT) may be complicated by pulmonary embolism, post-thrombotic syndrome, and phlegmasia cerulea dolens. Due to these complications, the American Venous Forum now recommends thrombus removal for large or symptomatic thrombus burden. The AngioJet Solent Proxy and Omni thrombectomy sets are indicated for use in iliofemoral and lower extremity veins with a diameter ≥3 mm. The device has quickly become a preferred device among the available mechanical thrombectomy options. The AngioJet system has been demonstrated as both efficacious and safe as a method of thrombectomy in lower extremity DVT. This chapter discusses two techniques to utilize the AngioJet device in iliofemoral DVT.

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Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis

European Journal of Radiology ◽

10.1016/j.ejrad.2008.04.015 ◽

2009 ◽

Vol 71 (2) ◽

pp. 350-355 ◽

Cited By ~ 40

Author(s):

Hong-Jian Shi ◽

You-Hua Huang ◽

Tao Shen ◽

Qiang Xu

Keyword(s):

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Mechanical Thrombectomy ◽

Percutaneous Mechanical Thrombectomy ◽

Catheter Directed Thrombolysis

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Treatment of Symptomatic Lower Extremity Acute Deep Venous Thrombosis: Role of Mechanical Thrombectomy

Vascular ◽

10.2310/6670.2007.00070 ◽

2007 ◽

Vol 15 (5) ◽

pp. 297-303 ◽

Cited By ~ 3

Author(s):

Andre Biuckians ◽

George H. Meier

Keyword(s):

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Mechanical Thrombectomy ◽

Current Treatment ◽

Treatment Modalities ◽

Clinical Consequence ◽

Venous Thrombus ◽

Postphlebitic Syndrome ◽

Valvular Function

Systemic anticoagulation with heparin or its unfractionated derivatives followed by warfarin therapy has been the mainstay of treatment in patients with lower extremity deep venous thrombosis (DVT). Although heparin is an effective treatment modality in preventing thrombus propagation, it provides minimal therapeutic effect in dissolving preexisting venous thrombus. The clinical consequence of DVT, owing in part to loss of venous endothelial and valvular function, is postphlebitic syndrome or chronic venous insufficiency. Current advances in endovascular therapy have resulted in various endovascular thrombectomy systems that can effectively remove a large venous thrombus burden, which may represent a potential advantage of preserving venous valvular function and thereby reduce the likelihood of postphlebitic syndrome. In this article, we review a variety of surgical and interventional methods in venous thrombus removal. Current treatment modalities using mechanical thrombectomy devices and pharmacomechancial thrombectomy strategy are also discussed.

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