Pre and post market experience with the Angel® catheter to evaluate efficacy, complication rates, and management strategy. Retrospective search of our database yielded 11 patients who underwent Angel® catheter placement from January 2016 to July 2018 with subsequent involvement of the interventional radiology service. Patient demographics, primary diagnosis, length of hospital stay, days from admission to catheter placement, days from catheter placement to removal, approach, catheter insertion length, time from placement to anticoagulation, specialty of operator, level of training, clot burden prior to retrieval, final catheter position, presence of imaging-proven deep venous thrombosis (DVT) whilst catheter in place, need for additional procedures, and complications of Angel® catheter were recorded (Table 1). All 11 patients (9 men, 2 women) underwent Angel® catheter placement at bedside under ultrasound guidance by 11 non-radiologist physicians (100%) of which 9 (81.8%) were in-training. Principal reason for admission was intracranial hemorrhage (ICH) for all patients with 9 due to trauma. Mean catheter insertion length was 25.3±4.2 cm. Catheters were left in place on average 13±3.4 days prior to first removal attempt with 8 of 11 (72.7%) catheters thrombosed at that time. 6 out of 11 (54.6%) required suprarenal IVC filter before removal while 7 of 11 (63.6%) overall required additional procedures prior to or for removal. Catheter placement to start of anticoagulation was 12.3±4.4 days. Admission to catheter placement was 4.1±1.9 days while overall length of stay was 46.5±26.6 days. One patient required contralateral replacement following unintentional removal while another patient had pulmonary embolism despite catheter placement. Based on our limited experience, Angel® catheter is associated with a high rate of caval thrombosis, need for additional invasive procedures, and increased morbidity.Table 1Angel® Catheter PerformanceCharacteristicsNoIndications Contraindication to pharmacologic prophylaxis11 (100%) Trauma9 Non-traumatic ICH2Facility location of catheter placement ICU bedside11 (100%)Approach: Right femoral11 Left femoral1*Operator Specialty: Non-radiologist11 (100%)Operator level of training: In training9 (81.82%)Time between admission and device insertion (days)4.09 ± 1.92Time between insertion and removal (days)13 ± 3.44Time between placement and starting anticoagulation (days)12.3 ± 4.4Average insertion length (cm)25.33 ± 4.21Final catheter position on abdominal radiograph T122 L1-L26 L2-L32 L3-L41DVT on Doppler ultrasound while catheter in place4 Right3 Left1Clot detection before retrieval Total8 (72.73%)Clot burden Extensive4 Large0 Moderate1 Small3Accidental catheter removal1Pulmonary embolism1No. requiring additional procedures: Overall7 (63.63%) Suprarenal filter placement6 (54.55%)*Accidental catheter removalDVT, deep vein thrombosis; ICH, intracranial hemorrhage; ICU, intensive care unit. Open table in a new tab