TY - JOUR
T1 - Procedural outcomes associated with use of the AngioVac System for right heart thrombi
T2 - A safety report from RAPID registry data
AU - Moriarty, John M.
AU - Liao, Millie
AU - Kim, Grace Hyun J.
AU - Yang, Eric
AU - Desai, Kush
AU - Ranade, Mona
AU - Plotnik, Adam N.
N1 - Funding Information:
The institutions and associated investigators who participated in the RAPID registry are as follows: UCLA Medical Center (John Moriarty, Adam Plotnik), Eastern Virginia Medical School/Sentara Healthcare (David Dexter), University of Southern California (David Shavelle), University of Colorado (Paul J Rochon), Allegheny General Hospital (Mithun Chakravarthy, David Lasorda), Washington University (Mohamed Zayed, Gerald Fortuna, John Ohman), Cedars Sinai Medical Center (Danny Ramzy), Franciscan Health (Charles Kiell), Montefiore Hospital (Yosef Golowa, Jacob Cynamon), Swedish Heart and Vascular Institute (Eric Lehr), Ochsner Clinic (Zola N’Dandu, Stephen Jenkins), Charleston Area Medical Center (Christopher Adams), Northwestern University (Kush Desai, Daniel Schimmel), Mt Sinai Medical Center (Aaron Fischman, Robert Lookstein, Rahul Patel), Mayo Clinic (Harladur Bjarnason), Mt Carmel Hospital (Noah Jones), Greenville Memorial Hospital (Bruce Gray), Integris Health (Bryan Cogar, Jeffrey Sparling), Baptist Health (John Craig), Central Iowa Hospital (Nicholas Southard), and Oklahoma Heart Institute (Eugene Ichinos). Medical writing assistance was provided by Larry Yost from The Atticus Group, LLC (Portsmouth, NH, USA). Funding for the RAPID registry, including data collection, monitoring statistical analysis, and medical writing, was provided by AngioDynamics, Inc. (Latham, NY, USA).
Publisher Copyright:
© The Author(s) 2022.
PY - 2022/6
Y1 - 2022/6
N2 - Background: Right heart thrombi can be a source of considerable morbidity and mortality, especially when associated with pulmonary embolism. Methods: To understand the safety and procedural efficacy associated with vacuum-assisted thrombectomy using the AngioVac System (AngioDynamics, Latham, NY, USA) to remove right heart thrombi, we conducted a subanalysis of the Registry of AngioVac Procedures in Detail (RAPID) multicenter registry representing 47 (20.1%) of 234 participants in the registry. Forty-two (89.4%) patients had thrombi located in the right atrium alone, three (6.4%) in the right ventricle alone, and two (4.3%) in both the right atrium and ventricle. Four (8.5%) patients had concomitant caval thrombi, three (6.4%) also had catheter-related thrombi, and one (2.1%) patient had both caval and catheter-related thrombi with their right heart thrombi. Results: Extracorporeal bypass time was less than 1 hour for 39 (83.0%) procedures. Seventy to 100% removal of thrombus was achieved in 59.6% of patients. Estimated blood loss was less than 250 cc for 43 procedures (91.6%). Mean hemoglobin decreased from 10.7 ± 2.2 g/dL preoperatively to 9.6 ± 1.6 g/dL postoperatively. Transfusions were administered for eight procedures (17.0%), with only one (2.1%) patient receiving more than 2 units of blood. Six patients (12.8%) experienced procedure-related adverse events, including three (6.4%) patients who experienced distal emboli and three (6.4%) patients who developed bleeding-related complications. All adverse events resolved prior to discharge. There was one death (2.1%) reported that was not procedure related. Conclusion: Vacuum-assisted thrombectomy can be performed safely in patients with right heart thrombi. ClinicalTrials.gov Identifier: NCT04414332.
AB - Background: Right heart thrombi can be a source of considerable morbidity and mortality, especially when associated with pulmonary embolism. Methods: To understand the safety and procedural efficacy associated with vacuum-assisted thrombectomy using the AngioVac System (AngioDynamics, Latham, NY, USA) to remove right heart thrombi, we conducted a subanalysis of the Registry of AngioVac Procedures in Detail (RAPID) multicenter registry representing 47 (20.1%) of 234 participants in the registry. Forty-two (89.4%) patients had thrombi located in the right atrium alone, three (6.4%) in the right ventricle alone, and two (4.3%) in both the right atrium and ventricle. Four (8.5%) patients had concomitant caval thrombi, three (6.4%) also had catheter-related thrombi, and one (2.1%) patient had both caval and catheter-related thrombi with their right heart thrombi. Results: Extracorporeal bypass time was less than 1 hour for 39 (83.0%) procedures. Seventy to 100% removal of thrombus was achieved in 59.6% of patients. Estimated blood loss was less than 250 cc for 43 procedures (91.6%). Mean hemoglobin decreased from 10.7 ± 2.2 g/dL preoperatively to 9.6 ± 1.6 g/dL postoperatively. Transfusions were administered for eight procedures (17.0%), with only one (2.1%) patient receiving more than 2 units of blood. Six patients (12.8%) experienced procedure-related adverse events, including three (6.4%) patients who experienced distal emboli and three (6.4%) patients who developed bleeding-related complications. All adverse events resolved prior to discharge. There was one death (2.1%) reported that was not procedure related. Conclusion: Vacuum-assisted thrombectomy can be performed safely in patients with right heart thrombi. ClinicalTrials.gov Identifier: NCT04414332.
KW - Clot in transit (CIT)
KW - endovascular therapy
KW - pulmonary embolism (PE)
KW - venous thromboembolism (VTE)
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U2 - 10.1177/1358863X211073974
DO - 10.1177/1358863X211073974
M3 - Article
C2 - 35176918
AN - SCOPUS:85124846630
SN - 1358-863X
VL - 27
SP - 277
EP - 282
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
IS - 3
ER -