BackTable / VI / Podcast / Episode #191

Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond

with Dr. S. Jay Mathews

In this episode, Interventional Radiologist Sabeen Dhand talks with Interventional Cardiologist S. Jay Mathews about novel techniques for arterial thrombectomy, including a discussion on using large bore devices, a variety of technique tips and tricks, and what's on the horizon for new devices/techniques.

Sponsored by:

Boston Scientific Eluvia Drug-Eluting Stent
Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond with Dr. S. Jay Mathews on the BackTable VI Podcast)
Ep 191 Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond with Dr. S. Jay Mathews
00:00 / 01:04

BackTable, LLC (Producer). (2022, March 5). Ep. 191 – Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. S. Jay Mathews discusses Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond on the BackTable 191 Podcast

Dr. S. Jay Mathews

Dr. S. Jay Mathews is the director of the Cardiac Catheterization Lab, the co-director of tje Structural Heart Program, and the director of the PERT Program with Manatee Memorial in Sarasoa, Florida.

Dr. Sabeen Dhand discusses Novel Techniques for Arterial Thrombectomy: Large Bore & Beyond on the BackTable 191 Podcast

Dr. Sabeen Dhand

Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.

Show Notes

In this episode, interventional cardiologist Dr. S. Jay Mathews and our host Dr. Sabeen Dhand discuss various devices used in arterial thrombectomy, including large bore aspiration catheters, the preclose system, separators, and stentrievers.

Dr. Mathews clarifies the definition of “large bore” as a catheter that is 8 Fr or larger. He notes these devices face some resistance in the interventional community, due the belief that arteries may be size prohibitive. However, he notes that the pre-close systems make arterial closure very feasible. Large bore catheters are able to achieve higher aspiration force compared to smaller catheters. Dr. Mathews prefers to use the Lightning 7 or 12 systems from Penumbra because of their angled/atraumatic catheter tips and their flexibility in navigation.

In cases of highly organized thrombus, Dr. Mathews may use separators to break up the clot into smaller and more manageable parts. He also speaks about using filters to capture the clot, but always in conjunction with aspiration, to prevent distal embolization.

The doctors also discuss the role of thrombolysis. Although thrombolysis procedure time is shorter than that of thrombectomy, patients remain ischemic for longer, leading to more reperfusion symptoms. Before placing a lysis catheter, Dr. Mathews recommends re-establishing some flow and creating a channel for more effective delivery of tPA.

Finally, we talk about new research in thrombus morphology and how this will affect future innovation in ultrasonic energy and nano-magnetic particles.

Resources

Penumbra Lightning Catheter:
https://www.penumbrainc.com/indigo-lightning/

Noninvasive thrombectomy of graft by nano-magnetic ablating particles:
https://www.nature.com/articles/s41598-021-86291-2

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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