The AngioVac Device and Its Anesthetic Implications

Ram, Harish; Gerlach, Rebecca M.; Conte, Antonio Hernandez; Ramzy, Danny; Jaramillo-Huff, Ashley; Gerstein, Neal S.

doi:10.1053/j.jvca.2016.12.017

Cited by 11 publications

(11 citation statements)

References 42 publications

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“…The reader is referred to a recent review by Ram et al. 10 for detailed descriptions of the AngioVac procedure, intraprocedural imaging, and reported complications.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal Echocardiography Diagnosis of Tricuspid Valve Injury During AngioVac Percutaneous Pulmonary Embolectomy

Boisen

Iyer

2018

CASE

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“…The reader is referred to a recent review by Ram et al. 10 for detailed descriptions of the AngioVac procedure, intraprocedural imaging, and reported complications.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal Echocardiography Diagnosis of Tricuspid Valve Injury During AngioVac Percutaneous Pulmonary Embolectomy

Boisen

Iyer

2018

CASE

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“…The second-generation AngioVac device offers several advantages over the earlier version of device. 83 A metaanalysis showed that the use of AngioVac device provides a viable minimally invasive alternative for extracting right atrial thrombus. However, the rate of successful extraction and mortality are significantly worse in patients with PE.…”

Section: Management Of Patients With Right Atrial Thrombosismentioning

confidence: 99%

Right Atrial Thrombosis and Pulmonary Embolism: A Narrative Review

Anfinogenova

Vasiltseva

Vrublevsky

et al. 2020

Semin Thromb Hemost

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Prompt diagnosis of pulmonary embolism (PE) remains challenging, which often results in a delayed or inappropriate treatment of this life-threatening condition. Mobile thrombus in the right cardiac chambers is a neglected cause of PE. It poses an immediate risk to life and is associated with an unfavorable outcome and high mortality. Thrombus residing in the right atrial appendage (RAA) is an underestimated cause of PE, especially in patients with atrial fibrillation. This article reviews achievements and challenges of detection and management of the right atrial thrombus with emphasis on RAA thrombus. The capabilities of transthoracic and transesophageal echocardiography and advantages of three-dimensional and two-dimensional echocardiography are reviewed. Strengths of cardiac magnetic resonance imaging (CMR), computed tomography, and cardiac ventriculography are summarized. We suggest that a targeted search for RAA thrombus is necessary in high-risk patients with PE and atrial fibrillation using transesophageal echocardiography and/or CMR when available independently on the duration of the disease. High-risk patients may also benefit from transthoracic echocardiography with right parasternal approach. The examination of high-risk patients should involve compression ultrasonography of lower extremity veins along with the above-mentioned technologies. Algorithms for RAA thrombus risk assessment and protocols aimed at identification of patients with RAA thrombosis, who will potentially benefit from treatment, are warranted. The development of treatment protocols specific for the diverse populations of patients with right cardiac thrombosis is important.

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“…It is usually performed with an extracorporeal cardiopulmonary bypass circuit with transesophageal echocardiography guidance and general anesthesia. [8][9][10][11] The CAT8 Indigo Mechanical Aspiration System (Penumbra Inc., Alameda, California) is FDA-approved for the removal of soft, fresh thrombi in the arterial and venous system. Others have utilized this system for aspiration of vegetations during transvenous pacemaker lead extraction.…”

mentioning

confidence: 99%

Clinical outcomes of percutaneous debulking of tricuspid valve endocarditis in intravenous drug users

Akhtar¹,

Walker²,

Shakur

et al. 2021

Cathet Cardio Intervent

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Objectives A retrospective case series of a percutaneous approach to debulk tricuspid valve endocarditis (TVE) using an 8 French mechanical aspiration system in patients with a history of intravenous drug use (IVDU) was reported. IVDU associated TVE is increasing in the United States and is associated with high mortality despite early surgical debridement. Patients with advanced disease, shock, and respiratory failure may not be candidates for surgical debridement or replacement. These patients have recurrent events despite medical therapy Methods About 25 patients with IVDU associated TVE with persistent bacteremia confirmed by repeat blood cultures after 72 hr of sensitivity directed antibiotics and presence of pulmonary emboli confirmed by computed tomographic (CT) scan, who had undergone percutaneous aspiration were included. Patients were all deemed high risk for surgical debridement by a CT surgeon and evaluated by an infectious disease consultant. Procedures were performed under moderate sedation with intracardiac echo and a steerable guide with a CAT8 Penumbra aspiration catheter. Results There were no intraprocedural deaths or complications. About 36% had septic shock on presentation. Survival of index hospitalization was 88%. Repeat blood cultures showed no growth on all surviving patients. Readmission rate was 4% (n = 1) at 1 month. About 40% (n = 2) patients with septic shock survived at 1 month compared with 100% survival (n = 20) in those without shock. Presence of septic shock was associated with reduced survival at 1 month (p < .01). Conclusion Percutaneous mechanical aspiration with an 8 Fr system is a feasible, minimally invasive alternative to surgical debulking. Mortality remains high in those presenting with septic shock. Further studies are needed to evaluate long‐term outcomes.

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The AngioVac Device and Its Anesthetic Implications

Cited by 11 publications

References 42 publications

Transesophageal Echocardiography Diagnosis of Tricuspid Valve Injury During AngioVac Percutaneous Pulmonary Embolectomy

Transesophageal Echocardiography Diagnosis of Tricuspid Valve Injury During AngioVac Percutaneous Pulmonary Embolectomy

Right Atrial Thrombosis and Pulmonary Embolism: A Narrative Review

Clinical outcomes of percutaneous debulking of tricuspid valve endocarditis in intravenous drug users

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