Step-by-Step ICE-Guided Aspiration Thrombectomy: Gastrointestinal Bleeding Patient With Device-Related Thrombus on Watchman FLX.

ABSTRACT:

Objectives

Device-related thrombus (DRT) remains a significant complication in the field of left atrial appendage occlusion (LAAO). In patients who have difficulty tolerating long-term anticoagulation, treatment options are limited. We present a step-by-step intracardiac echocardiography (ICE)-guided AngioVac (AngioDynamics) challenging case in a 71-year-old woman with a gastrointestinal bleeding tendency and a highly mobile thrombus on a Watchman FLX device (Boston Scientific).

Key steps

We obtained a 26-F DrySeal (Gore Medical) venous access, a 15-F extracorporeal membrane oxygenation cannula arterial access, and a 3-dimensional ICE access. We performed a challenging transseptal crossing using an Agilis medium curl catheter (Abbott) and an electrified Astato wire (Asahi In

SUBMITTER: Lai LKL 

PROVIDER: S-EPMC11830240 | biostudies-literature | 2025 Feb

REPOSITORIES: biostudies-literature