Successful Retrieval of the Detached Porous Metallic Tip of a Mechanical Aspiration Catheter during Thrombectomy in a Case with May–Thurner Syndrome: A Case Report

Abstract

Modern, minimally invasive techniques used to treat deep venous thrombosis, such as percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis, have gained worldwide acceptance. PMT has the advantage of speed and is also associated with improved outcomes, shortened hospital stays, and low complication rates. The main complications associated with PMT have been primarily due to iatrogenic vascular damage resulting in perforation, embolic occlusion, and arteriovenous fistula formation; to date, there has been no publication in the literature describing complications resulting from device failure. We present an unusual complication of PMT resulting from detachment of the catheter tip during thrombectomy and bailout technique employed.

Keywords

deep venous thrombosis - percutaneous mechanical thrombectomy - May-Thurner syndrome

• References

• 1 Nyamekye I, Merker L. Management of proximal deep vein thrombosis. Phlebology 2012; 27 (2, Suppl 2): 61-72
• 2 Moudgill N, Hager E, Gonsalves C, Larson R, Lombardi J, DiMuzio P. May-Thurner syndrome: case report and review of the literature involving modern endovascular therapy. Vascular 2009; 17 (6) 330-335
• 3 Suwanabol PA, Tefera G, Schwarze ML. Syndromes associated with the deep veins: phlegmasia cerulea dolens, May-Thurner syndrome, and nutcracker syndrome. Perspect Vasc Surg Endovasc Ther 2010; 22 (4) 223-230
• 4 Hölper P, Kotelis D, Attigah N, Hyhlik-Dürr A, Böckler D. Longterm results after surgical thrombectomy and simultaneous stenting for symptomatic iliofemoral venous thrombosis. Eur J Vasc Endovasc Surg 2010; 39 (3) 349-355
• 5 May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology 1957; 8 (5) 419-427
• 6 O'Sullivan GJ, Semba CP, Bittner CA , et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol 2000; 11 (7) 823-836
• 7 Thijs W, Rabe KF, Rosendaal FR, Middeldorp S. Predominance of left-sided deep vein thrombosis and body weight. J Thromb Haemost 2010; 8 (9) 2083-2084
• 8 Bush RL, Lin PH, Lumsden AB. Management of thrombosed dialysis access: thrombectomy versus thrombolysis. Semin Vasc Surg 2004; 17 (1) 32-39
• 9 Kasirajan K, Gray B, Ouriel K. Percutaneous AngioJet thrombectomy in the management of extensive deep venous thrombosis. J Vasc Interv Radiol 2001; 12 (2) 179-185
• 10 Bérczi V, Deutschmann HA, Schedlbauer P, Tauss J, Hausegger KA. Early experience and midterm follow-up results with a new, rotational thrombectomy catheter. Cardiovasc Intervent Radiol 2002; 25 (4) 275-281