Key result
Active malignancy does not impact technical success or survival during AngioVac right atrial thrombectomy.
Why the study?
Right atrial thrombus carries high mortality and lacks management consensus, particularly in high-risk cancer patients where AngioVac aspiration thrombectomy may offer a safer intervention.
Case-Control (n=44)
No
Answers are grounded in this paper and cite their sources.
OBJECTIVES . The aim of this study was to test the hypothesis that endovascular aspiration thrombectomy of right atrial thrombus (RAT) using the AngioVac device is as safe and effective in patients with cancer as those without cancer. BACKGROUND . RAT is a uniquely challenging clinical presentation of venous thromboembolism (VTE) due to its low incidence and historically high-risk of mortality due to thrombus propagation into the pulmonary arteries. There is a lack of consensus regarding management, particularly in high-risk cancer patients. Endovascular aspiration thrombectomy utilizing the AngioVac device is effective in removal of right atrial thrombus and may be a safer option for patients with cancer in whom avoidance of higher-risk intervention is preferred. METHODS . This was an institutional review board-approved retrospective single-center case control study of patients with RAT who underwent AngioVac aspiration thrombectomy between August 2013 and July 2020. Analysis of patient demographics and clinical characteristics, thrombus-related factors, and operative details was performed. Primary endpoints included survival, safety, and technical success. RESULTS . A total of 44 patients met inclusion criteria, 20 of whom with active malignancy. The oncology group had a significantly higher Charlson comorbidity index (p = 0.01). Comparative outcomes between the oncology and non-oncology group showed no difference in survival (p = 0.8) or technical success (OR 3, 95% CI 0.83-10.9). There were nine complications, including six minor, one moderate, one severe, and one death. CONCLUSION . AngioVac aspiration thrombectomy of RAT is as safe and effective in patients with cancer as those without cancer.
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Callese et al. (2021) conducted a case-control in Right atrial thrombus (n=44). Active malignancy vs. No active malignancy was evaluated on Technical success (>70% thrombus aspiration) (OR 3, 95% CI 0.83-10.9). Active malignancy did not significantly impact technical success (OR 3) or survival in patients undergoing AngioVac aspiration thrombectomy for right atrial thrombus compared to patients without cancer.
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