Interim outcomes of mechanical thrombectomy for deep vein thrombosis from the All-Comer CLOUT Registry

Utility of a percutaneous mechanical thrombectomy device in retrieval of an iatrogenic intravascular foreign body

“…In the CLOUT (ClotTriever outcomes) registry, the rate of serious adverse events with the ClotTriever through 30 days was 0.4%. 3 We have not experienced events such as renal failure with the Inari ClotTriever system—a complication we have observed with the AngioJet rheolytic thrombectomy system (Boston Scientific, Marlborough, MA). 7 IVUS, which is more sensitive than venography, should be used throughout the procedure.…”

“…The Inari ClotTriever thrombectomy system was developed for use in the venous system for thrombus removal in a single setting. 3 , 6 It has an expandable nitinol coring element that provides wall-to-wall apposition. 4 , 5 In our patient, this coring element was able to engage and retrieve the chronically retained IVFB, in addition to the thrombus.…”

“…Balloon maceration of thrombus was performed with a 14 x 60 mm Atlas Gold angioplasty balloon (Becton, Dickinson and Company, Franklin Lakes, NJ). After venoplasty of the axillo-subclavian and innominate veins, 4 passes of the ClotTriever device were performed from the superior vena cava to the brachial vein (3,6,9 and 12 o'clock positions; 90 degrees' rotation with each pass) using pullback technique. In addition to acute and subacute thrombi, the Inari thrombectomy system was also able to retrieve the retained catheter in two fragments (figure 4).…”

“…The Inari ClotTriever system (Inari Medical, Irvine, CA) is a more recently developed mechanical thrombectomy device that has shown utility in the treatment of acute, subacute, and chronic deep vein thrombosis (DVT) by removal of the obstructive thrombus and restoration of venous outflow. 2 , 3 , 4 Thrombolytic agents will generally not be required with the use of ClotTriever system and patients will not require monitoring in the intensive care unit afterward. 3 , 5 More recently, our center has shown the utility of the ClotTriever system in the treatment of calcified in-stent restenosis in the iliofemoral venous system.…”

“… 2 , 3 , 4 Thrombolytic agents will generally not be required with the use of ClotTriever system and patients will not require monitoring in the intensive care unit afterward. 3 , 5 More recently, our center has shown the utility of the ClotTriever system in the treatment of calcified in-stent restenosis in the iliofemoral venous system. 6 In the present report, we have described the case of a patient with a symptomatic left innominate vein DVT who also had had a retained catheter fragment from a tunneled infusion catheter in the left innominate vein.…”