Percutaneous Large Thrombus and Vegetation Evacuation in the Catheterization Laboratory

Abstract

Intracardiac and intravascular thrombi are associated with significant morbidity and mortality. Although surgery remains the gold standard treatment option, these patients often have multiple comorbidities that can make surgical options challenging. With advancements in catheter-based technologies, there are now percutaneous treatment options for these patients. The AngioVac is a percutaneous vacuum-assisted thrombectomy device FDA-approved for removal of intravascular debris that uses a venovenous extracorporeal membranous oxygenation circuit with a filter. Use of this device has now been reported in the removal of right atrial or iliocaval thrombi, debulking tricuspid vegetations, removal of vegetations from implantable cardiac devices, and pulmonary embolism.

Keywords: AngioVac; Cardiac implantable electronic devices; Extracorporeal membrane oxygenation; Iliocaval thrombus; Right atrial mass; Tricuspid valve endocarditis; Vacuum aspiration thrombectomy.