Single-Center Experience Using AngioVac with Extracorporeal Bypass for Mechanical Thrombectomy of Atrial and Central Vein Thrombi.

The AngioVac device (AngioDynamics, Inc, Queensbury, New York), a commercially available large-diameter aspiration cannula using extracorporeal venovenous bypass, is designed to facilitate en bloc mechanical thrombectomy of massive thrombi of the central vasculature. Between February 2014 and January 2015, seven consecutive patients, each presenting with large central thrombi of the iliac veins, vena cava, right atrium, or pulmonary artery, underwent thrombectomy. Partial or complete clot abatement was achieved in all instances. All patients survived the procedure. One case was complicated by embolization of septic thrombi. At most recent follow-up, one patient had died of causes unrelated to venous thrombosis; all other patients were living (median follow-up time 8 mo). Several technical and therapeutic insights were gained from our center's early experience.