BackgroundMechanical thrombectomy is an attractive option for managing iliofemoral deep venous thrombosis (DVT) and has the potential to decrease hospitalization. Currently, many payors require overnight admission. We analyzed patients undergoing mechanical thrombectomy with the Inari ClotTriever to determine the safety and efficacy of the treatment of iliofemoral DVT and to determine whether patients might be safe for discharge home on the same day based on the assessment of adverse outcomes.MethodsInstitutional review board approval was obtained to retrospectively analyze all patients on whom ClotTriever was used between May 2019 and January 2021. The charts were accessed for demographic and outcomes and analyzed with SPSS version 28 (SPSS, Inc., Armonk, NY).ResultsA total of 41 patients met inclusion criteria. Mean age was 55.56 ± 18.93 years and 56.1% were male. Mean body mass index was 31.97 ± 7.37. Prior DVT/pulmonary embolism (PE) was present in 51.2%, and 7.3% had a hypercoagulable disorder. There were 28 acute DVTs (68.3%) and 9.8% (4/41) had a thrombosed inferior vena cava filter.Intravascular ultrasound examination was utilized in 95.1% of cases (39/41). The most proximal extent of thrombosis was the inferior vena cava in 31.7% and common iliac vein in 53.7% of cases. Venoplasty and stenting were performed in 78% (32/41) and 48.8% (20/41) of patients. Sixty-one percent of DVTs (25/41) were left sided and 9.8% (4/41) were bilateral. May-Thurner syndrome was identified in 36.6% (15/41). Mean length of stay was 4.80 ± 13.65 days, and 25 patients (61%) were discharged in 1 or fewer days. Procedure to discharge time averaged 2.68 ± 5.87 days, median 1.00 days. Six patients required intensive care unit admission after the procedure, 50% of intensive care patients were admitted preprocedural with a PE and 33.3 had concomitant thrombolysis. Three patients were discharged same day, while 66% (27/41) were discharged on postprocedural day one. A total of eight patients required readmission at 69.63 ± 119.6 days. One patient developed a PE during the procedure, suffered cardiac arrest, and ultimately died.ConclusionsMechanical thrombectomy with the ClotTriever demonstrates an acceptable safety profile with few adverse events in the postprocedural period. One death in the cohort was identified and presumably due to a large pulmonary embolism. There is an overall acceptable safety profile and patients do not require inpatient level services in the period after mechanical thrombectomy. Same-day discharge or outpatient mechanical thrombectomy should be considered acceptable. BackgroundMechanical thrombectomy is an attractive option for managing iliofemoral deep venous thrombosis (DVT) and has the potential to decrease hospitalization. Currently, many payors require overnight admission. We analyzed patients undergoing mechanical thrombectomy with the Inari ClotTriever to determine the safety and efficacy of the treatment of iliofemoral DVT and to determine whether patients might be safe for discharge home on the same day based on the assessment of adverse outcomes. Mechanical thrombectomy is an attractive option for managing iliofemoral deep venous thrombosis (DVT) and has the potential to decrease hospitalization. Currently, many payors require overnight admission. We analyzed patients undergoing mechanical thrombectomy with the Inari ClotTriever to determine the safety and efficacy of the treatment of iliofemoral DVT and to determine whether patients might be safe for discharge home on the same day based on the assessment of adverse outcomes. MethodsInstitutional review board approval was obtained to retrospectively analyze all patients on whom ClotTriever was used between May 2019 and January 2021. The charts were accessed for demographic and outcomes and analyzed with SPSS version 28 (SPSS, Inc., Armonk, NY). Institutional review board approval was obtained to retrospectively analyze all patients on whom ClotTriever was used between May 2019 and January 2021. The charts were accessed for demographic and outcomes and analyzed with SPSS version 28 (SPSS, Inc., Armonk, NY). ResultsA total of 41 patients met inclusion criteria. Mean age was 55.56 ± 18.93 years and 56.1% were male. Mean body mass index was 31.97 ± 7.37. Prior DVT/pulmonary embolism (PE) was present in 51.2%, and 7.3% had a hypercoagulable disorder. There were 28 acute DVTs (68.3%) and 9.8% (4/41) had a thrombosed inferior vena cava filter.Intravascular ultrasound examination was utilized in 95.1% of cases (39/41). The most proximal extent of thrombosis was the inferior vena cava in 31.7% and common iliac vein in 53.7% of cases. Venoplasty and stenting were performed in 78% (32/41) and 48.8% (20/41) of patients. Sixty-one percent of DVTs (25/41) were left sided and 9.8% (4/41) were bilateral. May-Thurner syndrome was identified in 36.6% (15/41). Mean length of stay was 4.80 ± 13.65 days, and 25 patients (61%) were discharged in 1 or fewer days. Procedure to discharge time averaged 2.68 ± 5.87 days, median 1.00 days. Six patients required intensive care unit admission after the procedure, 50% of intensive care patients were admitted preprocedural with a PE and 33.3 had concomitant thrombolysis. Three patients were discharged same day, while 66% (27/41) were discharged on postprocedural day one. A total of eight patients required readmission at 69.63 ± 119.6 days. One patient developed a PE during the procedure, suffered cardiac arrest, and ultimately died. A total of 41 patients met inclusion criteria. Mean age was 55.56 ± 18.93 years and 56.1% were male. Mean body mass index was 31.97 ± 7.37. Prior DVT/pulmonary embolism (PE) was present in 51.2%, and 7.3% had a hypercoagulable disorder. There were 28 acute DVTs (68.3%) and 9.8% (4/41) had a thrombosed inferior vena cava filter. Intravascular ultrasound examination was utilized in 95.1% of cases (39/41). The most proximal extent of thrombosis was the inferior vena cava in 31.7% and common iliac vein in 53.7% of cases. Venoplasty and stenting were performed in 78% (32/41) and 48.8% (20/41) of patients. Sixty-one percent of DVTs (25/41) were left sided and 9.8% (4/41) were bilateral. May-Thurner syndrome was identified in 36.6% (15/41). Mean length of stay was 4.80 ± 13.65 days, and 25 patients (61%) were discharged in 1 or fewer days. Procedure to discharge time averaged 2.68 ± 5.87 days, median 1.00 days. Six patients required intensive care unit admission after the procedure, 50% of intensive care patients were admitted preprocedural with a PE and 33.3 had concomitant thrombolysis. Three patients were discharged same day, while 66% (27/41) were discharged on postprocedural day one. A total of eight patients required readmission at 69.63 ± 119.6 days. One patient developed a PE during the procedure, suffered cardiac arrest, and ultimately died. ConclusionsMechanical thrombectomy with the ClotTriever demonstrates an acceptable safety profile with few adverse events in the postprocedural period. One death in the cohort was identified and presumably due to a large pulmonary embolism. There is an overall acceptable safety profile and patients do not require inpatient level services in the period after mechanical thrombectomy. Same-day discharge or outpatient mechanical thrombectomy should be considered acceptable. Mechanical thrombectomy with the ClotTriever demonstrates an acceptable safety profile with few adverse events in the postprocedural period. One death in the cohort was identified and presumably due to a large pulmonary embolism. There is an overall acceptable safety profile and patients do not require inpatient level services in the period after mechanical thrombectomy. Same-day discharge or outpatient mechanical thrombectomy should be considered acceptable.