AVF Webinar: Mechanical Thrombectomy for VTE, New Directions
Selecting Patients for Aggressive DVT Treatment
Post-thrombotic syndrome develops in a third to half of DVT patients, and ATTRACT trial data show clot removal most benefits younger, active patients with proximal iliofemoral disease and low bleeding risk, while fem-pop-only DVT saw no benefit from intervention.
Risk-Stratifying and Treating High-Risk Pulmonary Embolism
Bova and simplified PESI scores using troponin, BNP, heart rate, and RV strain guide intervention decisions, and a submassive PE case demonstrated catheter-directed intelligent aspiration thrombectomy that lowered PA pressure and heart rate with minimal blood loss.
Comparing Mechanical Thrombectomy Devices
Aspiration systems with intelligent pressure sensing minimize blood loss during upper extremity and iliofemoral thrombectomy, while extraction baskets and lytic-infusing devices offer alternatives, with device choice depending on vessel size, clot chronicity, and prior stents.
Complex Cases: Stent Thrombosis and Narrow IVC Clot
A bilateral stent thrombosis case required reconstructing the iliac confluence with new stents after thrombectomy, and a narrow-caliber IVC case used an extraction basket device passed through the constricted segment to clear extensive iliocaval thrombus.
