The advent of newer thrombectomy devices has turned what were once hours-long surgical cutdowns into endovascular cases that last under an hour. In this episode of BackTable, host Dr. Sabeen Dhand is joined by Dr. Shang Loh from the University of Pennsylvania and Dr. Khanjan Nagarsheth from the University of Maryland to discuss the evolution of arterial thrombectomy devices and modern techniques for acute arterial occlusions.
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This podcast is supported by:
Inari Medical
https://www.inarimedical.com/artix-system
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SYNPOSIS
The episode highlights major technological advancements over the past decade, including the development of mechanical and computer-assisted thrombectomy systems. The physicians review key features of newer devices, such as the ability to combine aspiration with stent retrievers, the use of PTFE baskets to reduce distal embolization, and the advantage of maintaining wire access throughout the case.
They share strategies for managing specific cases, including acute femoral-popliteal occlusions with distal reconstitution, intraoperative ischemic pain due to flow arrest, trauma-related thrombosis, and cases complicated by extensive calcification and chronic vascular disease. As vascular surgeons, they also discuss the ongoing role of open approaches, outlining when surgical cutdown is indicated and where they prefer endovascular first. The conversation further explores challenges such as acute limb ischemia, stent thrombosis, and visceral artery thrombosis, emphasizing the importance of staying current with rapidly evolving technologies to improve procedural efficiency and patient outcomes.
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TIMESTAMPS
00:00 - Introduction
02:04 - Evolution of Arterial Thrombosis Treatment
04:11 - New Devices and Techniques
10:42 - Case Studies and Practical Applications
24:26 - Techniques and Devices for Thrombectomy
25:33 - Managing Flow and Patient Safety
27:25 - Surgical vs. Endovascular Approaches
29:25 - Dealing with Complications and Failures
37:50 - Visceral Thrombosis and Advanced Techniques
41:09 - Future of Thrombectomy Devices
44:27 - Closing Remarks
