Allegheny Health Network, Saint Vincent Heart and Vascular Institute, Erie, Pennsylvania, USA.
Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Catheter Cardiovasc Interv. 2022 Aug;100(2):261-265. doi: 10.1002/ccd.30294. Epub 2022 Jun 1.
Right-sided infective endocarditis is a common entity for which surgical intervention is frequently high-risk. Considering its invasive nature, potential complications, and challenging patient population, a less invasive endovascular option is desirable. The previous series have demonstrated the feasibility of percutaneous therapy for tricuspid valve (TV) vegetation utilizing a filter-based bypass circuit. However, the limited availability of a specialized team, resources, procedural complexity, and large bore sheath size restrict the broad adoption of this technique. The Inari FlowTriever System (Inari Medical) is an endovascular, catheter-based, aspiration, and mechanical thrombectomy system indicated for the removal of large-volume venous thrombus and pulmonary emboli. Independent of anesthesia, perfusion, or advanced imaging, this device's characteristics uniquely improve the operator's ability to safely remove unwanted debris from complex anatomy. This report describes the first, utilization of the Inari FlowTriever System for the removal of massive and inoperable TV vegetation.
右侧感染性心内膜炎是一种常见病症,手术干预通常风险较高。考虑到其侵袭性、潜在并发症和具有挑战性的患者群体,一种微创的腔内治疗方法是理想的选择。之前的系列研究已经证明了经皮治疗三尖瓣(TV)赘生物利用基于过滤器的旁路循环的可行性。然而,由于专门团队、资源的有限可用性、程序的复杂性以及大口径鞘管的尺寸限制了该技术的广泛应用。Inari FlowTriever 系统(Inari Medical)是一种血管内、基于导管的抽吸和机械血栓切除术系统,用于清除大体积静脉血栓和肺栓塞。该设备的特点独立于麻醉、灌注或高级成像,可显著提高操作人员从复杂解剖结构中安全清除不需要的碎片的能力。本报告介绍了首次使用 Inari FlowTriever 系统清除巨大且无法手术的 TV 赘生物。