Procedural outcomes associated with use of the AngioVac System for right heart thrombi: A safety report from RAPID registry data

John M. Moriarty*, Millie Liao, Grace Hyun J. Kim, Eric Yang, Kush Desai, Mona Ranade, Adam N. Plotnik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalVascular Medicine (United Kingdom)
Volume27
Issue number3
DOIs
StatePublished - Jun 2022

Keywords

  • Clot in transit (CIT)
  • endovascular therapy
  • pulmonary embolism (PE)
  • venous thromboembolism (VTE)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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