Mechanical Thrombectomy for the Treatment of Iliofemoral Deep Venous Thrombosis using the ClotTriever System: A Single-Centre Experience.

Abstract

Purpose: Iliofemoral deep venous thrombosis (DVT) is a significant cause of morbidity, with up to 50% of patients developing post-thrombotic syndrome (PTS). Mechanical thrombectomy (MT) has been proposed to restore early vessel patency and reduce PTS risk. This study evaluated outcomes of patients with iliofemoral DVT treated using Inari's ClotTriever system.

Materials and methods: A retrospective review was conducted of consecutive patients with iliofemoral DVT treated with ClotTriever. Technical success (defined as ≥ 75% thrombus removal and restoration of vein patency) and patency rates were assessed up to 12 months. Primary patency was defined as maintained patency without reintervention; assisted primary patency included reintervention without re-occlusion, and secondary patency referred to restored patency after occlusion. PTS was assessed using the Villalta score at a median follow-up of 4 months. Hospitalisation length, complications, and 30-day mortality were also recorded.

Results: Ninety limbs in 81 patients were treated. Thrombus chronicity was acute (30.0%), subacute (35.6%), and chronic (34.4%). Technical success was achieved in 98.9% of limbs. Primary patency rates at 6 and 12 months were 78.8% and 76.2%, respectively; assisted primary patency rates were 84.3% and 81.7%, and secondary patency remained 95.5%. Median Villalta score improved from 10.5 to 1.0 (p < 0.0001). At follow-up, 89.8% of limbs were PTS-free; 10.2% had mild PTS, with no moderate/severe cases. Median hospital stay was 1 day. No major complications or 30-day mortality occurred.

Conclusion: ClotTriever MT achieved high technical success, sustained patency, and significant symptom improvement. Comparative trials are needed to confirm its efficacy versus standard anticoagulation.