Revascularization of a thrombosed aortopulmonary shunt with the use of the AngioJet thrombectomy system

Abstract

We report the use of the AngioJet F140 rheolytic catheter to recannalize an acutely thrombosed aortopulmonary shunt in a 21-year-old female with palliated, complex congenital heart disease. After extracting the thrombus that filled the entire length of the shunt, three stents were placed at sites where the lumen was compromised by distortion or thrombus. Unobstructed flow was restored to the left pulmonary artery that persisted at 1-year follow-up.

Efficacy and safety of catheter‐based rheolytic and aspiration thrombectomy in children

“…Thrombosis is a cause of significant morbidity and mortality in children . Placement of central lines, cardiac catheterizations, surgical procedures, low cardiac output states, and coagulopathies may all result in significant thrombus formation in vessels of children . Recanalization of vessels and shunt grafts using methods such as balloon maceration have been previously described in children .…”

“…Recanalization of vessels and shunt grafts using methods such as balloon maceration have been previously described in children . However, published data regarding the use of specific rheolytic and manual aspiration thrombectomy systems in children have thus far has been limited to small series or case reports . As such, the efficacy and safety of these systems in children have not been reported in larger series.…”

Percutaneous catheter aspiration thrombectomy for the occluded stents of pulmonary artery in children with single ventricle physiology after fontan surgery

“…Percutaneous transcatheter mechanical thrombectomy can be broadly divided into three categories based on their mechanisms of action: (a) mechanical fragmentation of the embolus using guide‐wires, pigtail catheters, or balloons (flossing technique), (b) extraction using cup or basket devices, or (c) hydrodynamic fragmentation and aspiration of the embolus . Its use in children has been rarely reported .…”

“…One has vascular patency up to 2 years after the procedure; however, in another case PA was not patent despite intravascular stenting. . Our series also highlights the difficulty in maintaining long‐term vessel patency in the setting of PA hypoplasia.…”

Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease

“…Thrombolysis[791013] and mechanical removal of clots with thrombectomy catheter systems[91112] have been used to recanalize vessels as well, i.e. systemic to pulmonary artery shunts.…”