RESUMEN
Objective: In the present report, we have described the technical and clinical outcomes of percutaneous thrombectomy in the deep veins of the upper extremity and thorax using the ClotTriever system (Inari Medical, Irvine, CA). Methods: Fourteen patients with symptomatic deep venous occlusive disease in the upper extremity deep veins and thoracic central veins who had undergone thrombectomy using the ClotTriever system between October 2020 and January 2022 were reviewed. The technical results, adverse events, imaging follow-up data, and clinical outcomes were recorded. Results: Fourteen patients (seven men and seven women; mean age, 53.6 ± 13.3 years) constituted the study cohort. Of the 14 patients, 9 (64.3%) had had DVT due to intravascular invasion or external compression from known malignancy, 2 (14.3%) had had infected thrombi and/or vegetation due to Staphylococcus aureus refractory to intravenous antibiotic therapy, and 3 (21.4%) had had a benign etiology for thrombus formation. The presenting symptoms included upper extremity and/or facial swelling (n = 14), upper extremity pain (n = 6), fever (n = 2), and dyspnea (n = 1). Thrombectomy with the ClotTriever system was successfully completed in all 14 patients. Seven patients (50.0%) had required additional venous stent reconstruction after thrombectomy to address the underlying stenosis. No major adverse events were noted. All the patients had experienced resolution of the presenting symptoms. Conclusions: For the management of symptomatic deep venous occlusive disease of the upper extremity deep veins and thoracic central veins, thrombectomy using the ClotTriever system was feasible with excellent technical and clinical success.
RESUMEN
To evaluate the effectiveness of a lecture series in increasing awareness and knowledge about common interventional radiology (IR) procedures amongst emergency medicine and internal medicine residents at a tertiary care academic medical center.A series of two 60-minute lectures was presented at both the Emergency and Internal Medicine weekly didactic conferences for the respective residency programs. The lectures covered the indications, contraindications, imaging, pre-procedure preparation, complications, and follow-up of common IR procedures, including both didactics as well as interactive question and answer segments. The first lecture included central venous access, IVC filters, and image-guided biopsies, and the second lecture covered biliary interventions, genitourinary interventions, and vascular embolization. Pre/post lecture assessments were given evaluating participant knowledge, and paired one-tailed t-tests were elucidated for evaluating differences in the mean scores.A total of 77 emergency and internal medicine resident physicians participated in assessments of the lecture series. There were significantly increased scores (P<0.001) after both of the lectures (36% to 82% on the first lecture and 44% to 65% on the second lecture), suggesting increased knowledge of the common IR procedures discussed in the lecture.This work demonstrated that educational initiatives such as lecture series implementation are effective methods to increase knowledge of common IR procedures and raise awareness of the specialty among referring providers.
