EnVast Mechanical Thrombectomy After Thrombus Aspiration Failure in a STEMI With a Massive Thrombotic Burden

Dario Bongiovanni MD, Francesco Loizzi MD, Antonio Landi MD, Léa Utsch Med Vet, Marco Araco MD, Michael Joner MD and Marco Valgimigli MD, PhD
JACC: Cardiovascular Interventions, 2023-01-09, Volume 16, Issue 1, Pages 112-115, Copyright © 2023 American College of Cardiology Foundation

The management of coronary lesions with large thrombotic burden still poses challenges in contemporary practice and remains associated with poor outcomes.

A 55-years-old overweight male patient was admitted to our catheterization laboratory for late-presenting ST-segment elevation myocardial infarction (STEMI) and ongoing angina for 24 hours. The coronary angiography documented diffuse coronary ectasia with thrombotic occlusion of the mid-right coronary artery ( Figure 1A ). Initial balloon angioplasty failed to restore flow, allowing the visualization of a large and still occlusive thrombotic lesion ( Figure 1B ), which triggered administration of intravenous tirofiban. Thrombus aspiration was performed with the Export (Medtronic) device. During each passage, aspiration had to be aborted beyond the proximal thrombotic edge, owing to complete lumen tip obstruction by thrombotic material. Three catheter passages were performed without flow restoration.

Dr. Dario Bongiovanni used Vesalio's EnVast as a bailout thrombectomy in no-flow STEMI after conventional thrombus aspiration failure. Histology showed predominantly red clots aspirated by conventional aspiration, whereas EnVast extracted mixed thrombi with a significantly greater prevalence of platelets and connective tissue. Our preliminary findings suggest that EnVast retrieved more complex and extensive thrombotic structures providing an improved thrombectomy....read the full study here.

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VESALIO is dedicated to advancing the care of patients suffering from vascular occlusion by providing physicians with superior technology designed to improve clinical outcomes. 26 strokes and 10 resulting deaths occur each minute due to vascular occlusion. VESALIO is driving innovation to improve care for patients in critical need and benefit the physicians that treat them. With NeVa(TM), enVast(TM), NeVa NET(TM), and NEVA VS (TM), VESALIO will continue to grow and innovate in the vascular intervention field. Follow us to stay updated on our activities and innovation.