1 German Aortic Center Hamburg, Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
J Endovasc Ther. 2018 Oct;25(5):550-553. doi: 10.1177/1526602818792568. Epub 2018 Aug 5.
To present the technique for removing mural thrombus from the ascending aorta using the AngioVac System.
The technique is demonstrated in a 66-year-old woman who presented with free-floating mural thrombus in the ascending aorta and was considered unsuitable for either open (comorbidities) or endovascular approaches (high risk of stroke). Because of the free-floating thrombus, the Angiovac system was suggested, although it is approved for only the venous system. The technique was adapted for the arterial system with the 2 access points being (1) the proximal left subclavian artery with a 10-mm conduit for device access and (2) the right femoral vein. The AngioVac cannula and the reinfusion cannula were inserted into the artery and vein, respectively. The extracorporeal bypass circuit was created, and the carotid arteries were clamped during aspiration (<1 minute). The mural thrombus was aspirated successfully. The patient had an uneventful postoperative course with no signs of free thrombus on the postoperative or follow-up computed tomography angiograms.
The use of the AngioVac System seems to be a feasible technique for aspiration of thrombus from the ascending aorta. Expanding this therapeutic option for patients unsuitable for open or endovascular repair may be proven efficient in the near future.
介绍使用 AngioVac 系统从升主动脉中清除壁血栓的技术。
该技术在一名 66 岁的女性中进行演示，该女性患有游离壁升主动脉血栓，不适合开放（合并症）或血管内（中风风险高）方法。由于游离血栓，建议使用 Angiovac 系统，尽管该系统仅批准用于静脉系统。该技术通过以下 2 个入路（1）近端左锁骨下动脉，使用 10mm 导管进行器械进入，（2）右侧股静脉，适用于动脉系统。将 AngioVac 套管和再灌注套管分别插入动脉和静脉。建立体外旁路循环，并在抽吸过程中夹闭颈动脉（<1 分钟）。成功抽吸壁血栓。患者术后恢复顺利，术后或随访 CT 血管造影未见游离血栓迹象。
使用 AngioVac 系统似乎是一种从升主动脉中抽吸血栓的可行技术。在不久的将来，为不适合开放或血管内修复的患者扩展这种治疗选择可能会被证明是有效的。
