Removal of Caval and Right Atrial Thrombi and Masses Using the AngioVac Device: Initial Operative Experience

John M. Moriarty, Ramsey Al-Hakim, Anshuman Bansal, Jonathan K. Park

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose To describe initial single-center experience with a thrombectomy device in managing right atrial and caval thrombi, tumors, and vegetations. Materials and Methods A retrospective analysis of AngioVac thrombectomy performed in 16 patients (mean age 53 y ± 13; 8 men, 8 women) between August 2013 and August 2015 was performed. Indications included right atrial mass/thrombus (6/16; 37.5%) and iliocaval thrombus (10/16; 62.5%). Procedural success was defined as aspiration of > 70% volume of atrial mass/thrombus or restoration of antegrade caval flow. Results Procedural success was achieved in 4/6 (67%) right atrial masses/thrombi and 10/10 (100%) caval thrombi. All patients (8/8; 100%) with caval thrombus presenting with swelling/edema had improvement or resolution of symptoms. There were no procedural or periprocedural mortalities; complications included one major (6.3%; intraprocedural pulmonary embolus) and one minor (6.3%; access site hematoma not requiring transfusion) complication. Of 16 patients, 14 (87.5%) survived to discharge at a mean of 10 days ± 8 (range, 1–23 d), and 12 patients (75%) were alive at last known follow-up at a mean of 385 days ± 267 (range, 63–730 d). At a mean of 194 days ± 177 (range, 41–372 d), 4/16 (25%) patients were dead; no death was related to AngioVac thrombectomy. At a mean of 66 days ± 21 (range, 49–90 d) after intervention, 3/14 (21.4%) cases with procedural success had local recurrence of mass/thrombus. Conclusions AngioVac thrombectomy can be performed with high procedural success with clinical benefit in patients with right atrial and caval masses/thrombi.

Original languageEnglish (US)
Pages (from-to)1584-1591
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number10
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

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Venae Cavae
Thrombosis
Equipment and Supplies
Thrombectomy
Patient Rights
Embolism
Hematoma
Edema
Recurrence
Lung
Mortality

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Removal of Caval and Right Atrial Thrombi and Masses Using the AngioVac Device : Initial Operative Experience. / Moriarty, John M.; Al-Hakim, Ramsey; Bansal, Anshuman; Park, Jonathan K.

In: Journal of Vascular and Interventional Radiology, Vol. 27, No. 10, 01.10.2016, p. 1584-1591.

Research output: Contribution to journalArticle

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abstract = "Purpose To describe initial single-center experience with a thrombectomy device in managing right atrial and caval thrombi, tumors, and vegetations. Materials and Methods A retrospective analysis of AngioVac thrombectomy performed in 16 patients (mean age 53 y ± 13; 8 men, 8 women) between August 2013 and August 2015 was performed. Indications included right atrial mass/thrombus (6/16; 37.5{\%}) and iliocaval thrombus (10/16; 62.5{\%}). Procedural success was defined as aspiration of > 70{\%} volume of atrial mass/thrombus or restoration of antegrade caval flow. Results Procedural success was achieved in 4/6 (67{\%}) right atrial masses/thrombi and 10/10 (100{\%}) caval thrombi. All patients (8/8; 100{\%}) with caval thrombus presenting with swelling/edema had improvement or resolution of symptoms. There were no procedural or periprocedural mortalities; complications included one major (6.3{\%}; intraprocedural pulmonary embolus) and one minor (6.3{\%}; access site hematoma not requiring transfusion) complication. Of 16 patients, 14 (87.5{\%}) survived to discharge at a mean of 10 days ± 8 (range, 1–23 d), and 12 patients (75{\%}) were alive at last known follow-up at a mean of 385 days ± 267 (range, 63–730 d). At a mean of 194 days ± 177 (range, 41–372 d), 4/16 (25{\%}) patients were dead; no death was related to AngioVac thrombectomy. At a mean of 66 days ± 21 (range, 49–90 d) after intervention, 3/14 (21.4{\%}) cases with procedural success had local recurrence of mass/thrombus. Conclusions AngioVac thrombectomy can be performed with high procedural success with clinical benefit in patients with right atrial and caval masses/thrombi.",
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N2 - Purpose To describe initial single-center experience with a thrombectomy device in managing right atrial and caval thrombi, tumors, and vegetations. Materials and Methods A retrospective analysis of AngioVac thrombectomy performed in 16 patients (mean age 53 y ± 13; 8 men, 8 women) between August 2013 and August 2015 was performed. Indications included right atrial mass/thrombus (6/16; 37.5%) and iliocaval thrombus (10/16; 62.5%). Procedural success was defined as aspiration of > 70% volume of atrial mass/thrombus or restoration of antegrade caval flow. Results Procedural success was achieved in 4/6 (67%) right atrial masses/thrombi and 10/10 (100%) caval thrombi. All patients (8/8; 100%) with caval thrombus presenting with swelling/edema had improvement or resolution of symptoms. There were no procedural or periprocedural mortalities; complications included one major (6.3%; intraprocedural pulmonary embolus) and one minor (6.3%; access site hematoma not requiring transfusion) complication. Of 16 patients, 14 (87.5%) survived to discharge at a mean of 10 days ± 8 (range, 1–23 d), and 12 patients (75%) were alive at last known follow-up at a mean of 385 days ± 267 (range, 63–730 d). At a mean of 194 days ± 177 (range, 41–372 d), 4/16 (25%) patients were dead; no death was related to AngioVac thrombectomy. At a mean of 66 days ± 21 (range, 49–90 d) after intervention, 3/14 (21.4%) cases with procedural success had local recurrence of mass/thrombus. Conclusions AngioVac thrombectomy can be performed with high procedural success with clinical benefit in patients with right atrial and caval masses/thrombi.

AB - Purpose To describe initial single-center experience with a thrombectomy device in managing right atrial and caval thrombi, tumors, and vegetations. Materials and Methods A retrospective analysis of AngioVac thrombectomy performed in 16 patients (mean age 53 y ± 13; 8 men, 8 women) between August 2013 and August 2015 was performed. Indications included right atrial mass/thrombus (6/16; 37.5%) and iliocaval thrombus (10/16; 62.5%). Procedural success was defined as aspiration of > 70% volume of atrial mass/thrombus or restoration of antegrade caval flow. Results Procedural success was achieved in 4/6 (67%) right atrial masses/thrombi and 10/10 (100%) caval thrombi. All patients (8/8; 100%) with caval thrombus presenting with swelling/edema had improvement or resolution of symptoms. There were no procedural or periprocedural mortalities; complications included one major (6.3%; intraprocedural pulmonary embolus) and one minor (6.3%; access site hematoma not requiring transfusion) complication. Of 16 patients, 14 (87.5%) survived to discharge at a mean of 10 days ± 8 (range, 1–23 d), and 12 patients (75%) were alive at last known follow-up at a mean of 385 days ± 267 (range, 63–730 d). At a mean of 194 days ± 177 (range, 41–372 d), 4/16 (25%) patients were dead; no death was related to AngioVac thrombectomy. At a mean of 66 days ± 21 (range, 49–90 d) after intervention, 3/14 (21.4%) cases with procedural success had local recurrence of mass/thrombus. Conclusions AngioVac thrombectomy can be performed with high procedural success with clinical benefit in patients with right atrial and caval masses/thrombi.

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