Initial Oxford Experience of the Inari ClotTriever in Mechanical Venous Thrombectomy for Iliofemoral Deep Vein Thrombosis

Background: The role of mechanical thrombectomy technology is increasing in the management of occlusive deep vein thrombosis (DVT). This article describes the initial experience of 11 cases within a tertiary UK center in the use of the ClotTriever device for mechanical venous thrombectomy.

Materials and Methods: A prospective database of all cases of venous thrombectomy with the ClotTriever device performed over a 9-month period was documented between 15/04/21 and 12/01/22 at a single tertiary UK hospital. Demographics, initial presentation, and immediate procedural outcomes were recorded. Symptom improvement was assessed alongside follow-up vascular Doppler ultrasound study at 24 hours, 2 weeks, 3 months, and 6 months postprocedure. Clot clearance was assessed during the procedure with visual estimation of a contrast venogram and intravascular ultrasound. Technical success was defined as successful clot evacuation without the need for postintervention thrombolysis or the use of additional thrombectomy devices. Reocclusion rates at 6 months and subsequent need for reintervention of the treated segment were also measured.

Result: Eleven individual patients were treated with the Inari ClotTriever device (7 male, 4 female). Median age was 53 years (range: 18–70 years). General anesthesia was used in 55% (6 patients) and local anesthesia for 45% (5 patients) of cases. Popliteal vein of the affected side was used for access in all cases. Median number of passes with the ClotTriever device was 5 (range 4–12). Complete clot evacuation ranged between 80 and 90%. Average number of iliac/femoral vein stents inserted was 1.55 (0–4). Primary assisted patency was 100%, with a 3-month primary patency rate of 82% (two requiring reintervention within 3 months). There was no requirement for thrombolytic therapy or intensive care unit admission. The 30-day mortality was zero. Reocclusion rate at 6 months was zero.

Conclusions: Initial experience suggests that the use of the ClotTriever device for mechanical venous thrombectomy in iliofemoral DVT is safe and effective. Follow-up vascular ultrasound demonstrated good identification of the requirement for reintervention. These cases contribute to the developing evidence base underlying venous thrombectomy and the increasing range of options for patients presenting with occlusive venous disease.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
17 August 2022