Thrombectomy Using

Suction Filtration and

Veno-venous Bypass:
Single Center Experience
with a Novel Device

Cameron W. Donaldson et al.

— Harvard Medical School

Speaker: Bin Zhong

2019.10.16
Materials and Methods

Background:
The appearance of inferior vena cava or right sided Clot Clot
intracardiac thrombus may prompt consideration of
thrombectomy as a method to prevent new or
worsening pulmonary embolism (PE).

Device: AngioVac cannula

• 18 Fr. cannula (6 mm);
• a balloon-actuated, expandable, funnel-shaped
distal tip that can be advanced over a guidewire
into the venous system percutaneously or via a
surgical cut-down;
• inserted via the internal jugular or right common
femoral vein;
• connected to a pump circuit with the reinfusion
cannula.
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Materials and Methods

Working procedure: 1 2

1. Insert cannula and dilator into 6

interested area on a guidewire
after a vascular cutdown.
2. Remove dilator and guidewire,
cannula temporarily clamped.
4
3. Insert reinfusion catheter.
5
4. Include the filter: priming and
de-airing.
5. The extracorporeal circuit is
activated and blood circulates.

6. Repeatedly advance and withdraw 3

the cannula slightly to clear debris.

7. Vascular closure.

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Results and limitations

Results:
• Successful evacuation in 73% of cases.

Limitations:
• Size;
• Stiffness;
• Lack of maneuverability;
• Inevitably some blood remains in the circuit;
• In acute totally occlusive thrombus, flow rates may
be too low for extraction.

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Idea and improvements

Limitation：In acute totally occlusive thrombus, flow rates may be too low for extraction.

thrombus

Proposed improvement: Mechanical design => break up occlusive thrombus into small pieces

rotating

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eggbeater
Thank You!

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