Right atrial thrombi: Percutaneous mechanical thrombectomy
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The current therapeutic options for right atrial thrombi—surgical embolectomy and thrombolysis— are associated with high mortality and such patients often have contraindications to these therapeutic options. the purpose of this study was to evaluate the feasibility of endovascular right atrial embolectomy. Two patients with contraindications to thrombolysis and surgery were treated by a femoral approach. A catheter was placed in the right atrium, under fluoroscopic control, and a basket device was used to trap the thrombus. The location and extent of the thrombus was established before the procedure by transesophageal echocardiography (TEE) and the procedure was performed with TEE and fluoroscopy. Thrombi were withdrawn in the basket into the inferior vena cava (IVC) and a filter was inserted by a jugular approach and positioned in the IVC, just above the thrombi. The basket was removed leaving the thrombus below the filter. One patient died immediately after the procedure. In conclusion, endovascular extraction of right atrial thrombi may represent a potential therapeutic alternative, particularly in patients with contraindications to thrombolysis and surgery.
Key wordsAtrial thrombi Pulmonary emboli Endovascular treatment Thrombolytic therapy
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- 2.Taupin JM, Chapoutot L, Metz D, Ouzan J, Pollet E, Elaerts J, Bajolet A (1988) Thrombus flottant de l’OD dans l’embolie pulmonaire aiguë: Aspects cliniques, echocardiographiques et incidences thérapeutiques. Ann Cardiol Angeiol (Paris) 37: 243–247Google Scholar
- 10.Kronik G (1990) From the European Working Group on Echocardiography. The European cooperative study on the clinical significance of the right heart thrombi. Eur Heart J 10: 1046–1059Google Scholar
- 12.Goldsmith JC, Lollar P, Hoak JC (1990) Massive fatal pulmonary emboli with fibrinolytic therapy. Circulation 64: 1068–1081Google Scholar