Management of inferior vena cava thrombosis with the FlowTriever and ClotTriever systems

Although inferior vena cava (IVC) thrombosis is infrequently encountered, it carries a significant risk of post-thrombotic syndrome and pulmonary embolus. Recent studies show no difference in the incidence of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis (DVT) treated...

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Bibliographic Details
Published in:Journal of vascular surgery. Venous and lymphatic disorders (New York, NY) NY), 2021-05, Vol.9 (3), p.615-620
Main Authors: Shah, Noor G., Wible, Brandt C., Paulisin, Joseph A., Zaki, Mina, Lamparello, Patrick, Sista, Akhilesh, Sadek, Mikel, Jacobowitz, Glenn R., Maldonado, Thomas S.
Format: Article
Language:English
Subjects:
Aspiration thrombectomy
Inferior vena cava thrombosis
Mechanical thrombectomy
Post-thrombotic syndrome
Venous thromboembolism
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Summary:Although inferior vena cava (IVC) thrombosis is infrequently encountered, it carries a significant risk of post-thrombotic syndrome and pulmonary embolus. Recent studies show no difference in the incidence of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis (DVT) treated with pharmacothrombolysis vs anticoagulation alone; however, there is an associated increased risk of bleeding. The treatment of IVC thrombosis is less well-studied and the hemodynamic changes may be more significant with pharmacothrombolysis, although the bleeding risk remains. The ClotTriever and FlowTriever systems remove thrombus from veins without the use of thrombolytics. Our study evaluates outcomes of patients undergoing mechanical thrombectomy for the treatment of IVC thrombosis using the ClotTriever and FlowTriever devices. A retrospective chart review was performed to identify consecutive patients who underwent mechanical thrombectomy for the treatment of IVC thrombosis using the ClotTriever and/or FlowTriever systems from November 2018 to January 2020 at four data-sharing institutions. The decision of which device(s) to use was at the discretion of the surgeon. Patient demographics, symptomatology, and imaging characteristics were captured at presentation and follow-up. A total of 15 patients met the inclusion criteria; 10 were male, and the average age was 59 years. The majority of patients were symptomatic at presentation (n = 14), had a prior history of DVT (n = 13), and had a preexisting IVC filter (n = 8). Eleven patients presented with acute onset (6 months; n = 8). All patien
ISSN:2213-333X
2213-3348
DOI:10.1016/j.jvsv.2020.09.008