Transcatheter vacuum‐assisted left‐sided mass extraction with the AngioVac system

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Abstract
Objectives: To study the safety and efficacy of AngioVac for left‐sided transcatheter vacuum‐assisted mass extraction (TVME).Background: The AngioVac system is approved for right‐sided TVME and has emerged as an effective and safe alternative for open surgical treatment. The use of the AngioVac device for aspiration of left‐sided TVME has been limited.Methods: Consecutive patients from two Michigan centers who underwent left‐sided TVME were included. Data on patient demographics, procedural information, in‐hospital and follow‐up events were collected through electronic medical records review. Technical success was defined as aspirating of 70%–100% of the material.Results: Ten patients (mean age 58.3 [±17.3] years, 50% male) were included. Indications for TMVE were in large for recurrent embolic events. All patients underwent bilateral cerebro‐embolic protection using the Sentinel device. The total mean procedure time was 192.5 (±47.5) min of which the meantime for active aspiration (bypass time) was 9.3 (±4.2) min. The circuit configuration was: arteriovenous (AV) in four cases and arterioarterial (AA) in six cases. Successful aspiration was achieved in 80% of cases. No complications were reported (range follow‐up 1–16 months).Conclusions: Our small case series demonstrates the feasibility and safety of the AngioVac system in left‐sided mass extraction. Larger trials are needed to further demonstrate its effectiveness and safety and potentially apply for on‐label use.

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