Vacuum-assisted thrombectomy (VAT) is a mechanical suction device that can be deployed to aspirate thrombi in the heart and vascular system. Successful percutaneous aspiration of iliocaval, right heart, and pulmonary arterial thrombi have been reported, in addition to the debulking of intravascular and intracardiac masses and vegetations. VAT is indicated for patients who are poor surgical candidates and/or have a contraindication to thrombolysis. This review discusses the mechanism, current results, potential clinical indications, and limitations of VAT for iliocaval and intracardiac mass removal.
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- Intravascular and intracardiac masses include thrombi, tumors, and vegetations, impacting the heart's chambers and circulation.
- Treatment has traditionally been surgical or involves anticoagulation, but there's a shift towards minimally invasive techniques due to patient complexities.
- The AngioVac System, initially for right-sided heart thrombi, has expanded its use to treat right-sided endocarditis and left-sided masses effectively.
A Retrospective Analysis of AngioVac Outcomes at a Tertiary Care Center.
J Soc Cardiovasc Angiogr Interv
June 2024
Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia.
Background: The AngioVac system is a vacuum aspiration device approved for removal of right-sided cardiac thrombi. It has also been used for management of right-sided endocarditis in selected cases. Retrospective case series have reported high success rate and acceptable 30-day mortality, but there is limited data regarding outcomes beyond the immediate postoperative period.
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Vasc Specialist Int
June 2024
Department of Vascular Surgery, University General Hospital of Patras, Patras, Greece.
Paradoxical embolism through the foramen ovale is a rare and devastating event requiring urgent treatment. Herein, we present the case of a 23-year-old male who presented with a pulmonary embolism complicated by a left renal artery paradoxical embolism. Urgent vacuum-assisted thrombo-aspiration restored normal perfusion of the left kidney within 5 hours.
View Article and Find Full Text PDFTechnique for Recanalization of Sheath Introducer Occlusion due to Captured Thrombus during Mechanical Thrombectomy for Acute Ischemic Stroke: A Technical Note.
J Neuroendovasc Ther
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Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Osaka, Japan.
Objective: Mechanical thrombectomy (MT) is the gold standard treatment for acute ischemic stroke. During these interventions, a thrombus frequently obstructs a guiding catheter. The obstructed guiding catheter should be withdrawn before distal embolism occurs; however, albeit infrequently, the thrombus occludes even a sheath introducer (SI).
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Am J Cardiol
January 2024
Cardiology, Michigan State University, East Lansing, Michigan.
Tricuspid valve infective endocarditis (TVIE), often associated with vegetation in people who inject drugs, has introduced a less invasive option for vegetation removal: transcatheter vacuum-assisted mass extraction (TVME). This technique is emerging as an alternative to standard surgical debridement (SD) and valve repair. However, the comparative effectiveness of TVME versus SD in treating TVIE has yet to be investigated.
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