Mechanical clot disruption during pulmonary thromboembolectomy is safe: A propensity score-matched analysis.

Purpose: Aspiration thromboembolectomy is effective for treatment of high and intermediate-high risk pulmonary emboli (PE) but can be challenging when organized thrombus is present. Maceration using an expandable nitinol disk may be useful in these situations, but its safety has not been determined. The purpose of this study was to retrospectively assess the safety of this device when applied in the pulmonary vasculature, using a propensity-score matched group for comparison.

Effect of Filtered Blood Return on Outcomes of Pulmonary Aspiration Thrombectomy.

Objectives: To assess the effects of filtered blood reinfusion (FBR) on procedural outcomes of aspiration thrombectomy for pulmonary embolism (PE).

Materials And Methods: A total of 171 patients who underwent aspiration thrombectomy for intermediate-high-risk or high-risk PE between December 2018 and September 2022 were included, 84 of whom underwent thrombectomy with FBR and 87 without. Demographic data, vital signs, laboratory values, procedural details, pulmonary arterial pressures, transfusion needs, length of hospital stay, and procedure-related adverse events were recorded.

Reverse sheathing technique for iliocaval thrombectomy in the setting of IVC filters.

The Inari ClotTriever system (Inari Medical, Irvine, California) is safe and effective for the treatment of DVT. However, because it consists of a 31 cm coring device and collection bag that must be extended for use, application may be precluded by available intravascular "running room", such as in the presence of an IVC filter. Here we present a technique for bypassing IVC filters via retrograde deployment of the ClotTriever within a sheath, as illustrated in three cases.

Use of a funneled sheath for embolic protection during removal of thrombosed Simon Nitinol filters.

Inferior vena cava (IVC) filters should be removed when no longer needed, given their association with complications such as thrombosis of the IVC and lower extremities, fracture, migration, and growth into adjacent structures. While this is generally straightforward in the setting of retrievable filters, permanent filters present more of a challenge. In fact, many operators will not attempt to do so for fear of intraprocedural complications, among them, filter fracture and fragment embolization.

Six-Month Deep Vein Thrombosis Outcomes by Chronicity: Analysis of the Real-World ClotTriever Outcomes Registry.

Purpose: To analyze the first 250 patients from the prospective, multicenter, industry-sponsored ClotTriever Outcomes (CLOUT) registry, assessing the safety and effectiveness of mechanical thrombectomy for acute, subacute, and chronic deep vein thrombosis (DVT).

Materials And Methods: Real-world patients with lower extremity DVT were treated with the ClotTriever System (Inari Medical, Irvine, California). Adjuvant venoplasty, stent placement, or both were performed at the physician's discretion.