Publication Date

4-1-2019

Journal

The Texas Heart Institute Journal

DOI

10.14503/THIJ-17-6551

PMID

31236075

Publication Date(s)

April 2019

Language

English

PMCID

PMC6555294

PubMedCentral® Posted Date

4-1-2019

PubMedCentral® Full Text Version

Post Print

Published Open-Access

yes

Keywords

Female, Follow-Up Studies, Heart Ventricles, Humans, Male, Middle Aged, Pulmonary Artery, Pulmonary Embolism, Retrospective Studies, Suction, Thrombectomy, Tomography, X-Ray Computed, Treatment Outcome, Ventricular Function, Right

Abstract

Venous thromboembolism is a leading cause of cardiovascular death. Historically, surgical intervention has been associated with high morbidity rates. Pharmacologic therapy alone can be inadequate for patients with substantial hemodynamic compromise, so minimally invasive procedures are being developed to reduce clot burden. We describe our initial experience with using the AngioVac system to remove thromboemboli percutaneously. We reviewed all suction thromboembolectomy procedures performed at our institution from March 2013 through August 2015. The main indications for the procedure were failed catheter-directed therapy, contraindication to thrombolysis, bleeding-related complications, and clot-in-transit phenomena. We collected details on patient characteristics, procedural indications, thrombus location, hemodynamic values, cardiac function, pharmacologic support, and survival to discharge from the hospital. The Wilcoxon signed-rank test was used for statistical analysis. Thirteen patients (mean age, 56 ± 15 yr; 10 men) underwent suction thromboembolectomy; 10 (77%) survived to hospital discharge. The median follow-up time was 74 days (interquartile range [IQR], 23-221 d). Preprocedurally, 8 patients (62%) had severe right ventricular dysfunction; afterwards, 11 (85%) had normal function or mild-to-moderate dysfunction, and only 2 (17%) had severe dysfunction (

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