Benjamin Haupt1,2, Frank Merkle2,3, Thomas Dreizler1, Volkmar Falk4,5,6, Christoph Starck3,4,5. 1. Department of Perfusion, German Heart Center Berlin, Berlin, Germany. 2. Academy for Perfusion, German Heart Center Berlin, Berlin, Germany. 3. Steinbeis-Transfer-Institut Kardiotechnik, Steinbeis-Hochschule Berlin, Berlin, Germany. 4. Department of Cardiovascular Surgery, German Heart Center Berlin, Berlin, Germany. 5. DZHK (German Center for Cardiovascular Research), Berlin, Germany. 6. Department of Cardiothoracic Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Abstract
OBJECTIVES: The AngioVac system (AngioDynamics, Latham, NY, USA) provides a method for the minimally invasive, percutaneous aspiration of thrombus formations originating from the central venous system as well as solid matter such as lead vegetations and right atrial thrombi. METHODS: This retrospective, observational study describes the initial experience in 52 adult patients with the AngioVac system, focusing mainly on the development of the extracorporeal circuit to improve usability and safety. RESULTS: The mean patient age was 62.9 years (range 23-86 years). 22 patients were female and 30 were male. Indications for percutaneous aspiration were lead vegetations (n = 36; 69.2%), right atrial thrombi (n = 9; 17.3%), central venous thrombi (n = 5; 9.6%) and pulmonary embolisms (n = 2; 3.8%). Successful aspiration was performed in 44 cases (84.6%) and partial success was achieved in five patients (9.6%), while failure to remove thrombi or vegetations occurred in three cases (5.8%). Our practical experience led to the installation of a shunt line for recirculation and the implementation of safety features concerning air handling, which are also employed in minimally invasive extracorporeal bypass circuits. Initial tests monitored the level of negative pressure according to differences in flow and access sites but these still have to be validated on a larger scale. CONCLUSION: In this initial experience, the AngioVac system appeared to be safe regarding the extracorporeal circulation and the elimination of thrombi and lead vegetations.
OBJECTIVES: The AngioVac system (AngioDynamics, Latham, NY, USA) provides a method for the minimally invasive, percutaneous aspiration of thrombus formations originating from the central venous system as well as solid matter such as lead vegetations and right atrial thrombi. METHODS: This retrospective, observational study describes the initial experience in 52 adult patients with the AngioVac system, focusing mainly on the development of the extracorporeal circuit to improve usability and safety. RESULTS: The mean patient age was 62.9 years (range 23-86 years). 22 patients were female and 30 were male. Indications for percutaneous aspiration were lead vegetations (n = 36; 69.2%), right atrial thrombi (n = 9; 17.3%), central venous thrombi (n = 5; 9.6%) and pulmonary embolisms (n = 2; 3.8%). Successful aspiration was performed in 44 cases (84.6%) and partial success was achieved in five patients (9.6%), while failure to remove thrombi or vegetations occurred in three cases (5.8%). Our practical experience led to the installation of a shunt line for recirculation and the implementation of safety features concerning air handling, which are also employed in minimally invasive extracorporeal bypass circuits. Initial tests monitored the level of negative pressure according to differences in flow and access sites but these still have to be validated on a larger scale. CONCLUSION: In this initial experience, the AngioVac system appeared to be safe regarding the extracorporeal circulation and the elimination of thrombi and lead vegetations.
Entities:
Keywords:
AngioVac system; pacemaker lead thrombosis; pulmonary embolism; vacuum-assisted thrombectomy
Authors: Angelo Nascimbene; Sukhdeep S Basra; Kha Dinh; Jayeshkumar A Patel; Igor D Gregoric; Biswajit Kar Journal: Methodist Debakey Cardiovasc J Date: 2021-07-15