Does catheter-based embolectomy using Inari FlowTriever successfully treat right atrial clot-in-transit in high-risk patients with contraindications to surgery and thrombolytics?
Catheter-based embolectomy using the Inari FlowTriever system is a feasible treatment option for high-risk patients with right atrial clot-in-transit who have contraindications to surgery and thrombolytics.
In the previous literature, the prevalence of right atrial (RA) clot-in-transit associated with pulmonary embolism is around 4-18% with an associated mortality of 80-100% in untreated cases. Surgical thrombo-embolectomy has been the mainstay of treatment for stable patients but the data for percutaneous thrombo-embolectomy is lacking in the literature. We present a series of three cases of right atrium clot-in-transit treated with catheter-based therapies with Inari FlowTriever® (Inari Medical, Irvine, CA). Our three patients had different clinical profiles and presentations of right atrial clot-in-transit. All of the subjects had contraindications to surgical thrombo-embolectomy and thrombolytic therapy. Catheter based embolectomy using Inari FlowTriever® was successfully performed in all the patients. As the data on this intervention is sparse, our case series highlights successful catheter based thrombo-embolectomies in high-risk individuals with right atrial clot in-transit with or without pulmonary embolism.
Verma et al. (Mon,) studied this question.