Chronic iliofemoral DVT often contains wall-adherent thrombus poorly responsive to lysis. We report lytic-free thrombectomy using VenaCore. A 45-year-old man with acute-on-chronic right iliofemoral DVT (CEAP C4, VCSS 13) underwent popliteal access, VenaCore plus ClotTriever extraction, balloon angioplasty, IVUS-guided sizing, and selective stenting; simultaneous contrast via a coaxial 4 Fr sheath enhanced capture. Completion venography/IVUS showed restored inline flow with < 30% residual stenosis. He was discharged on day 3; at 1-month, duplex confirmed patency and VCSS improved to 7. VenaCore-assisted thrombectomy with IVUS-guided selective stenting appears feasible and effective for organized venous obstruction.
Malak et al. (Fri,) studied this question.