In Vivo Porcine Model of Acute Iliocaval Deep Vein Thrombosis

Abstract

Acute deep vein thrombosis (DVT) is a potentially life-threatening condition in which blood clots form in the venous system. Recently, a number of endovascular thrombectomy devices have been introduced to treat acute DVT. Given their varied efficacy and safety profiles, a clear need exists for further device innovation and enhancement. However, a major limitation in the testing, verification, and validation of new thrombectomy devices is a clinically representative large animal model of acute DVT. Unfortunately, existing approaches to creating DVT in porcine models are time-consuming, technically challenging, and yield inconsistent results. We therefore developed a rapid, technically straightforward, and reproducible protocol for induction of large-volume iliocaval DVTs in a living porcine host. This approach involves sequestering the iliocaval venous segment with standard balloon occlusion catheters, and a controlled limited infusion of a 25% ethanol solution within the sequestered static segment. We observed that this method was safe, technically straightforward, and reproducible in producing large-volume acute DVTs. We believe that this technique can be utilized as a standardized DVT model in the testing of future endovascular venous thrombectomy devices. Clinical Impact The study establishes a rapid, technically straightforward, and reproducible porcine large animal model for acute iliocaval deep vein thrombosis (DVT). The procedure can be performed with basic endovascular skillsets. With its procedural efficiency and consistency, the platform is promising for comparative in vivo testing of venous thrombectomy devices in a living host, and for future verification and validation studies to determine efficacy of novel thrombectomy devices relative to predicates.