Introduction
Dr. Mauro Bertoglio from the Vascular Surgery Department at the University Hospital of Turin, Italy, presented the effectiveness of Computer-Assisted Vacuum Thrombectomy (CAVT) in addressing thrombosis after Endovascular Aneurysm Repair (EVAR). The presentation focused on how this technique is applied to manage limb and aortic branch occlusions post-EVAR, with a technical success rate exceeding 90% in various clinical failure cases.
Key Points
1.Thrombosis and Occlusion Post-EVAR:
•Limb occlusion following EVAR is a common complication. CAVT can effectively remove clots in the occluded segment, restoring blood flow. Dr. Bertoglio referenced algorithms from studies like that of K. Meisenbacher, demonstrating the success of CAVT in real-world applications.
2.Chronic Limb Thrombosis Management:
•Dr. Bertoglio discussed how Rotarex devices, used in combination with CAVT, have significantly improved outcomes in managing chronic post-EVAR limb thrombosis, as seen in a 2024 study by Simonte et al.
Case Studies
•Case 1: A patient experienced limb occlusion 3 days after EVAR. CAVT successfully restored normal blood flow, and post-operative CT scans confirmed the complete removal of the thrombus.
•Case 2: A BEVAR patient developed acute mesenteric ischemia and kidney failure 12 months post-procedure. CAVT successfully cleared the thrombosis in the renal and mesenteric arteries, with the patient’s creatinine levels decreasing significantly.
Conclusion
1.CAVT is a safe and feasible technique for managing thrombosis after EVAR, especially in cases of limb and branch occlusion.
2.The high success rate of CAVT makes it an effective solution, particularly in catastrophic failures after BEVAR.
3.CAVT is likely to see broader application in more complex cases moving forward.
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