Successful cerebral protection during removal of large right atrial thrombus with AngioVac in a patient with patent foramen ovale and recent embolic stroke

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Presentation transcript:

Successful cerebral protection during removal of large right atrial thrombus with AngioVac in a patient with patent foramen ovale and recent embolic stroke Hunter M. Ray, MD, Zain Al Rstum, MD, Naveed U. Saqib, MD, FACS Journal of Vascular Surgery Cases and Innovative Techniques Volume 5, Issue 3, Pages 201-204 (September 2019) DOI: 10.1016/j.jvscit.2019.03.001 Copyright © 2019 The Author(s) Terms and Conditions

Fig 1 A, Initial transthoracic echocardiogram demonstrating 2.03- ×1.42-cm right atrial mass. B, Computed tomography angiogram of the chest demonstrating right atrial mass (arrow). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 201-204DOI: (10.1016/j.jvscit.2019.03.001) Copyright © 2019 The Author(s) Terms and Conditions

Fig 2 Transthoracic echocardiogram on hospital day 8 demonstrating 2.59- ×1.61-cm right atrial mass. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 201-204DOI: (10.1016/j.jvscit.2019.03.001) Copyright © 2019 The Author(s) Terms and Conditions

Fig 3 Angiogram demonstrating placement of the Sentinel Cerebral Protection System (CPS; Boston Scientific, Marlborough, Mass) with the proximal stent in the innominate artery (A), shaping of the catheter tip and selection of the left common carotid artery (B), and deployment of the distal filter in the left common carotid artery (C). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 201-204DOI: (10.1016/j.jvscit.2019.03.001) Copyright © 2019 The Author(s) Terms and Conditions

Fig 4 Fluoroscopy images demonstrating both the transfemoral approach (A) and the transjugular approach (B) with the AngioVac cannula noted in the right atrium with transesophageal echocardiography (TEE) probe for guidance. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 201-204DOI: (10.1016/j.jvscit.2019.03.001) Copyright © 2019 The Author(s) Terms and Conditions

Fig 5 Completion intraoperative transesophageal echocardiography (TEE) demonstrating nearly complete resolution of the right atrial mass after suction thrombectomy with the AngioVac system. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 201-204DOI: (10.1016/j.jvscit.2019.03.001) Copyright © 2019 The Author(s) Terms and Conditions