Agarwal Siddharth, Sosnofsky Christopher, Saum Jamie, Aggarwal Manu, Patel Sandeep
Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cardiology, Heritage College of Osteopathic Medicine, Athens, USA.
Cureus. 2020 Dec 14;12(12):e12071. doi: 10.7759/cureus.12071.
Intravenous catheters account for the majority of cases of upper extremity deep vein thrombosis (UEDVT), with a higher incidence in patients suffering from malignancy. Sequelae of UEDVT are similar to that of lower extremity DVT, comprising post-thrombotic syndrome and pulmonary embolism. While there are several treatment options for UEDVT including systemic anticoagulation, catheter-directed thrombolysis, and percutaneous mechanical thrombectomy, due to the absence of consistent guidelines regarding its management, treatment is often individualized based on patient characteristics, clinical factors, and technical considerations. We present a case of a 49-year-old female suffering from breast cancer with a central venous catheter (CVC) who came to the clinic with UEDVT and CVC malfunction and was successfully treated with mechanical thrombectomy using the ClotTriever System (Inari Medical, Irvine, CA). To our knowledge, this is the first report of the ClotTriever System being used to treat UEDVT and simultaneously salvage the CVC in a single session.
静脉导管是上肢深静脉血栓形成(UEDVT)的主要原因,在恶性肿瘤患者中发病率更高。UEDVT的后遗症与下肢深静脉血栓形成相似,包括血栓形成后综合征和肺栓塞。虽然UEDVT有多种治疗选择,包括全身抗凝、导管直接溶栓和经皮机械血栓切除术,但由于缺乏关于其管理的一致指南,治疗通常根据患者特征、临床因素和技术考虑进行个体化。我们报告一例49岁患有乳腺癌且带有中心静脉导管(CVC)的女性患者,该患者因UEDVT和CVC故障前来就诊,并使用ClotTriever系统(Inari Medical,尔湾,加利福尼亚州)成功进行了机械血栓切除术。据我们所知,这是首次报道使用ClotTriever系统单次治疗UEDVT并同时挽救CVC的病例。