Difference between revisions of "Pulmonary Embolism Mechanical Thrombectomy"

Line 1: Line 1:
 
=== Inari Medical===
 
=== Inari Medical===
* Standard venous access equipment
+
*[[File:Inari PE- 1.png|thumb|Pre-thrombectomy pulmonary arteriogram -  (47/26 mmHg, mean 33 mmHg)]]Standard venous access equipment
 
* 22 Fr Gore Dryseal sheath
 
* 22 Fr Gore Dryseal sheath
 
* 260cm Amplatz Super Stiff with a 1 cm floppy tip
 
* 260cm Amplatz Super Stiff with a 1 cm floppy tip
Line 17: Line 17:
 
* If no blood return, remove the aspiration catheter with suction engaged and flush with saline
 
* If no blood return, remove the aspiration catheter with suction engaged and flush with saline
 
* Repeat as necessary
 
* Repeat as necessary
[[File:Inari PE- 1.png|thumb|Pre-thrombectomy pulmonary arteriogram -  (47/26 mmHg, mean 33 mmHg)]]
 
 
[[File:Inari PE - 2.png|thumb|Post-thrombectomy pulmonary arteriogram -  (26/20 mmHg, mean 22 mmHg)]]
 
[[File:Inari PE - 2.png|thumb|Post-thrombectomy pulmonary arteriogram -  (26/20 mmHg, mean 22 mmHg)]]
 
[[File:Inari PE - 3.png|thumb|Aspirated clot burden]]
 
[[File:Inari PE - 3.png|thumb|Aspirated clot burden]]
  
 
<pdf page="2">File:Inari FT-Product Brochure.pdf</pdf>
 
<pdf page="2">File:Inari FT-Product Brochure.pdf</pdf>

Revision as of 08:26, 19 February 2019

Inari Medical

  • Pre-thrombectomy pulmonary arteriogram - (47/26 mmHg, mean 33 mmHg)
    Standard venous access equipment
  • 22 Fr Gore Dryseal sheath
  • 260cm Amplatz Super Stiff with a 1 cm floppy tip
  • Angled pigtail catheter
  • Bentson guidewire
  • Inari 20 Fr 95 cm aspiration catheter
  • Inari flowtriever device (optional)

Steps:

  • Femoral vein access
  • Pulmonary artery access using angled pigtail catheter, using a curved back end of the Bentson for stiffness and directionality may help
  • Pulmonary arteriogram, measure pulmonary arterial pressures, make decision for thrombectomy
  • 22 Fr Dryseal sheath exchange over Amplatz guidewire
  • Cross the pulmonary embolism with the 1cm floppy tipped Amplatz guidewire. A Vert catheter may help for selection.
  • Engage aspiration catheter onto the clot, begin aspiration
  • If no blood return, remove the aspiration catheter with suction engaged and flush with saline
  • Repeat as necessary
Post-thrombectomy pulmonary arteriogram - (26/20 mmHg, mean 22 mmHg)
Aspirated clot burden

Contributing Authors

Kevin Liu