Effect Of Intelligent Aspiration During Thrombectomy For Acute Venous Thrombosis
Brent Robertson, MD, Evan Neville, MD, Louis Graham Rucker, MD, Mark Broering, MD, Brian Kuhn, MD, Aaron Kulwicki, MD, Matthew Recht, MD, Patrick Muck, MD.
Trihealth-Good Samaritan Hospital, Cincinnati, OH, USA.
OBJECTIVES: Aspiration thrombectomy (AT) is an effective therapy for evacuation of acute thrombus. As a function of the aspiration technology, it also has the potential to remove fresh blood. The Lightning 12 Intelligent Aspiration system (Penumbra, Inc. Alameda) combines a large bore thrombectomy catheter with a flow monitoring pressure sensor to differentiate thrombus from fresh blood. This retrospective analysis compares outcomes between intermittent aspiration using Lightning 12 and continuous aspiration using CAT8 for treatment of acute venous thrombosis. METHODS: This was a single-center retrospective case-control study including patients undergoing AT with Lightning12 and age- and sex-matched patients undergoing AT with CAT8. The primary outcome was procedural blood loss. The secondary outcome was technical success defined as >70% thrombus reduction in a single session. RESULTS: A total of 9 patients (mean age 60.3 years, 55.6% F) underwent AT using Lightning 12. 27 patients (mean age 58.0 years, 55.6% F) underwent AT using CAT8. Mean procedural blood was 250 mL for the Lightning 12 group in comparison to 375 mL for the CAT8 group. The rate of single session technical success was 77.8% in the Lightning 12 group in comparison to 18.5% for the CAT8 group. CONCLUSIONS: These initial results suggest that aspiration thrombectomy using the Lightning 12 Intelligent Aspiration system appears safe and effective for the treatment of acute venous thrombosis without significant blood loss. In this analysis, intermittent aspiration using Lightning 12 was associated with less blood loss and higher rates of single session therapy. 
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