Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A, B) Intraprocedural transthoracic echocardiogram. Enlarged right atrium with a large serpiginous thrombus (red arrow) (C) Intraprocedural fluoroscopy. Aortic and mitral mechanical valves on the right, transthoracic echocardiogram probe in the center, and a 16-Fr FlowTriever sheath (Inari Medical, CA, USA) on the left side of the image, directed toward the right atrium. (D, E) Intraprocedural images: Advancement of a 16-Fr sheath via the right femoral vein and aspiration using the FlowTriever system sheath (Inari Medical, CA, USA) (F) Fresh right atrium thrombi extracted.

Article Snippet: Although the FlowTriever system (Inari Medical, CA, USA) offered larger-bore catheters (16–24 Fr), it was not available in a timely manner and was initially perceived as carrying a potential risk of atrial wall suction and perforation.

Techniques:

Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A–E) Intraprocedural transesophageal echocardiography. (A ) Large multilobed thrombus adherent to the interatrial septum (“octopus-like” morphology). ( B ) Multiple targeted aspirations with a deflectable catheter (yellow arrow). ( C ) Persistence of the main thrombotic component after removal of 1 of the lobes (red arrow). ( D, E ) Aspiration using 16-Fr FlowTriever sheath (Inari Medical, CA, USA) thrombectomy catheter (blue arrow) (F) Fresh thrombi extracted.

Article Snippet: Although the FlowTriever system (Inari Medical, CA, USA) offered larger-bore catheters (16–24 Fr), it was not available in a timely manner and was initially perceived as carrying a potential risk of atrial wall suction and perforation.

Techniques:

Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A–C) Screening transesophageal echocardiography. (A) Large thrombotic mass (red box) adhered to the distal tip of a transjugular line (blue arrow) and (B) 4 chamber view. Large mass in the right atrium (red arrow) (C) 4 chamber, x -plane view. Thrombotic mass prolapsing through de TV (pink lines) into the right ventricule. (D–F) Intraprocedural transesophageal echocardiography. (D) right ventricular outflow tract view. 24-Fr FlowTriever sheath sheath (Inari Medical, CA, USA) advanced into the right ventricular outflow tract over a Superstiff guidewire (green arrow). (E) 4 chamber view. Residual thrombus (red arrows) within the RA. (F) 4 chamber view. A 14-Fr deflectable sheath (green arrow) positioned in the right atrium.

Article Snippet: Although the FlowTriever system (Inari Medical, CA, USA) offered larger-bore catheters (16–24 Fr), it was not available in a timely manner and was initially perceived as carrying a potential risk of atrial wall suction and perforation.

Techniques:

Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A) Fluoroscopy image. Cerebral embolic protection system a Sentinel device (Boston Scientific, MA, USA). (B, C) Intraprocedural ICE. Thrombus attached to the interatrial septum entering a 14-Fr deflectable sheath (red arrow). (D, E) Pulmonary angiography. (D) Extensive thrombus within branches of the right pulmonary artery. (E) Final result with the FlowTriever catheter sheath (Inari Medical, CA, USA). (F ) Complete fresh thrombus extracted from the right pulmonary artery (top) and right atrium (bottom).

Article Snippet: Although the FlowTriever system (Inari Medical, CA, USA) offered larger-bore catheters (16–24 Fr), it was not available in a timely manner and was initially perceived as carrying a potential risk of atrial wall suction and perforation.

Techniques:

Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A, B) Intraprocedural transthoracic echocardiogram. Enlarged right atrium with a large serpiginous thrombus (red arrow) (C) Intraprocedural fluoroscopy. Aortic and mitral mechanical valves on the right, transthoracic echocardiogram probe in the center, and a 16-Fr FlowTriever sheath (Inari Medical, CA, USA) on the left side of the image, directed toward the right atrium. (D, E) Intraprocedural images: Advancement of a 16-Fr sheath via the right femoral vein and aspiration using the FlowTriever system sheath (Inari Medical, CA, USA) (F) Fresh right atrium thrombi extracted.

Article Snippet: Given the high embolic risk and the contraindication to proceeding with TTVR, percutaneous thromboaspiration through the existing venous access was performed using a 16-Fr FlowTriever catheter (Inari Medical, CA, USA), achieving complete removal after 1 single aspiration.

Techniques:

Journal: European Heart Journal. Case Reports

Article Title: Intracavitary percutaneous thromboaspiration as a rescue strategy across high-risk scenarios: a case series

doi: 10.1093/ehjcr/ytag397

Figure Lengend Snippet: (A–E) Intraprocedural transesophageal echocardiography. (A ) Large multilobed thrombus adherent to the interatrial septum (“octopus-like” morphology). ( B ) Multiple targeted aspirations with a deflectable catheter (yellow arrow). ( C ) Persistence of the main thrombotic component after removal of 1 of the lobes (red arrow). ( D, E ) Aspiration using 16-Fr FlowTriever sheath (Inari Medical, CA, USA) thrombectomy catheter (blue arrow) (F) Fresh thrombi extracted.

Article Snippet: Given the high embolic risk and the contraindication to proceeding with TTVR, percutaneous thromboaspiration through the existing venous access was performed using a 16-Fr FlowTriever catheter (Inari Medical, CA, USA), achieving complete removal after 1 single aspiration.

Techniques: