Deshmukh Ashwin P, Cornman-Homonoff Joshua
Department of Radiology, Yale New Haven Health-Bridgeport Hospital, Bridgeport, CT, USA.
Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
J Vasc Access. 2024 May;25(3):1020-1022. doi: 10.1177/11297298231162879. Epub 2023 Mar 27.
Catheter associated right atrial thrombus (CRAT) is an uncommon but potentially life-threatening condition. There are no established guidelines for management, and treatment ranges from systemic anticoagulation and thrombolysis to open surgery. While there have been reports on use of suction thrombectomy for right atrial thrombi, the feasibility and outcomes of suction thrombectomy in CRAT have not been described. These two cases describe a successful off-label use of two devices (Triever 20, Inari Medical, Irvine, CA, and AlphaVac, AngioDynamics, Latham, NY) for thrombectomy in CRAT. Both patients had near complete extraction of chronic appearing thrombus, with follow up imaging demonstrating complete resolution. Suction thrombectomy may have a unique role in management in CRAT, especially in cases of infected thrombi. A formal exemption from the institutional review board was obtained for publication.
