Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
J Vasc Interv Radiol. 2021 Apr;32(4):549-557.e3. doi: 10.1016/j.jvir.2020.09.012. Epub 2021 Jan 29.
To assess device and procedural safety and technical success associated with the use of the AngioVac System to remove vascular thrombi and cardiac masses.
The Registry of AngioVac Procedures in Detail (RAPID) study prospectively collected data for 234 patients receiving treatment with AngioVac at 21 sites between March 2016 and August 2019: 84 (35.9%) with caval thromboemboli (CTEs), 113 (48.3%) with right heart masses (RHMs), 20 (8.5%) with catheter-related thrombi (CRTs), and 4 (1.7%) with pulmonary emboli (PEs). Thirteen patients had a combination of procedures during the same admission.
Using the AngioVac system, 70%-100% thrombus or mass removal was achieved in 73.6% of patients with CTEs, 58.5% of patients with RHMs, 60% of patients with CRTs, and 57.1% of patients with PEs. Extracorporeal bypass time was < 1 hour for 176 (75.2%) procedures. Estimated blood loss was < 250 mL for 179 procedures (76.5%). Mean hemoglobin decreased from 10.4 g/dL ± 2.9 preoperatively to 9.4 g/dL ± 2.6 postoperatively. Transfusions were administered in 59 procedures (25.2%) with 47 transfusions (78.2%) being ≤ 2 U. There were 36 procedure-related complications, including 1 death.
The RAPID registry data demonstrate that the AngioVac System can be safely and effectively used to remove vascular thrombi and cardiac masses across a broad range of patient populations. The limited use of the device to remove pulmonary emboli in the present series precludes recommending the use of the AngioVac device for this indication.
评估使用 AngioVac 系统清除血管血栓和心脏肿块的设备和程序安全性及技术成功率。
血管内Vac 治疗详细登记研究（RAPID）前瞻性收集了 2016 年 3 月至 2019 年 8 月 21 个地点 234 例接受 AngioVac 治疗患者的数据：84 例（35.9%）为腔静脉血栓栓塞症（CTE），113 例（48.3%）为右心肿块（RHM），20 例（8.5%）为导管相关血栓（CRT），4 例（1.7%）为肺栓塞（PE）。13 例患者在同一住院期间进行了多种手术。
使用 AngioVac 系统，70%-100%的 CTE 患者、58.5%的 RHM 患者、60%的 CRT 患者和 57.1%的 PE 患者血栓或肿块得到了清除。176 例（75.2%）手术体外循环时间<1 小时。179 例（76.5%）失血量估计<250ml。术前平均血红蛋白为 10.4g/dL±2.9g/dL，术后为 9.4g/dL±2.6g/dL。59 例（25.2%）手术进行了输血，其中 47 例（78.2%）输血<2U。有 36 例与手术相关的并发症，包括 1 例死亡。
RAPID 登记数据表明，AngioVac 系统可安全有效地用于清除多种患者人群的血管血栓和心脏肿块。本系列中有限地使用该设备清除肺栓塞，不建议将 AngioVac 设备用于该适应证。
