Abstract
Objective To describe our institution's experience with the AngioVac system. Background Intracardiac and intravascular masses previously required surgical excision, but now, there are a number of minimally invasive options. With the advent of vacuum aspiration, more specifically the AngioVac System (AngioDynamics, NY, USA), there exists a system with both low mortality and minor complications. However, the number of retrospective studies remains limited. Outcome data for high-risk patients are also limited. Methods Data were collected and analyzed in patients who underwent AngioVac therapy at our tertiary care center from January 2014 to December 2020. Results Our results demonstrated a 93.3% intraoperative success rate and a 100% intraoperative survival rate. However, a number of complications, including but not limited to hematomas, anemia, and hypotension, occurred, as described below. Conclusions Our experiences demonstrated good outcomes and continue to support the usefulness of the AngioVac System. The data also support the use of AngioVac as a treatment option for the debulking or removal of right heart masses in critically ill patients.
Highlights
Intracardiac masses, right-sided cardiac thrombi, vegetations, and tumors, can be rare and life-threatening conditions and, are often difficult to manage
One such option is the AngioVac System (AngioVac Cannula and Circuit, AngioDynamics, NY, USA), a vacuum-assisted suction embolectomy device designed to remove fresh thrombi and vegetations in the right atrium and ventricle, superior and inferior vena cavae, and iliofemoral veins [3, 4]. e system has existed for a number of years, and its utility has been evaluated in a number of case studies [5,6,7]
The AngioVac System has been considered for off-label use for a variety of conditions including as an alternative to surgical thrombectomy in high-risk patients for the removal or debulking of infectious vegetations and benign or malignant tumors in the right atrium, ventricle, or tricuspid valve. ere are limited data regarding outcomes for these patients
Summary
Intracardiac masses, right-sided cardiac thrombi, vegetations, and tumors, can be rare and life-threatening conditions and, are often difficult to manage. Mortality rates are often high in untreated patients [1, 2] Treatment options for these patients traditionally include catheter-directed or systemic thrombolysis, embolectomy, and medical management alone. Catheter-based suction embolectomy has been successfully used for minimally invasive treatment of intravascular material One such option is the AngioVac System (AngioVac Cannula and Circuit, AngioDynamics, NY, USA), a vacuum-assisted suction embolectomy device designed to remove fresh thrombi and vegetations in the right atrium and ventricle, superior and inferior vena cavae, and iliofemoral veins [3, 4]. The AngioVac System has been considered for off-label use for a variety of conditions including as an alternative to surgical thrombectomy in high-risk patients for the removal or debulking of infectious vegetations and benign or malignant tumors in the right atrium, ventricle, or tricuspid valve. The purpose of this report is to describe our institution’s experiences and outcomes with the AngioVac System over the past 6 years
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