A Procedural Algorithm to Improve Imaging Efficiency in DVT Procedures with the ClotTriever System

Introduction: Global supply interruptions have limited the availability of contrast media, providing impetus for optimizing fluoroscopy use when treating deep vein thrombosis (DVT). This study evaluates the efficiency of a novel imaging algorithm for use with the ClotTriever System (Inari Medical, Irvine, CA).

Method(s): The analysis consisted of a prospective technique cohort (n = 21) and a retrospective cohort (n = 23) of patients treated with mechanical thrombectomy for lower extremity DVT of any chronicity. The imaging algorithm involves marking the starting position of the catheter superior to the target thrombus on the first device pass and indexing to that location throughout the intervention. Procedural characteristics including fluoroscopic time and radiation dose were recorded.

Result(s): Mean procedural fluoroscopy time (4.4 vs. 16.0 minutes) and mean radiation dose (67.9 vs. 397.0 mGy) were considerably decreased in the technique group when compared with the retrospective cohort. The mean number of device passes remained consistent (4.6 vs. 4.9), suggesting improved fluoroscopic efficiency.

Conclusion(s): This investigational imaging algorithm successfully reduced fluoroscopy time and radiation dose when treating DVT with the ClotTriever System, the most studied mechanical thrombectomy device in DVT.

Publication History

Article published online:
09 February 2023