top of page

BackTable / VI / Podcast / Episode #289

Treating Clot in Transit

with Dr. Rehan Quadri

In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit.

Sponsored by:

Inari Medical

Be part of the conversation. Put your sponsored messaging on this episode. Learn how.

Treating Clot in Transit with Dr. Rehan Quadri on the BackTable VI Podcast)
Ep 289 Treating Clot in Transit with Dr. Rehan Quadri
00:00 / 01:04

BackTable, LLC (Producer). (2023, February 6). Ep. 289 – Treating Clot in Transit [Audio podcast]. Retrieved from https://www.backtable.com

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

Sign Up:

Podcast Contributors

Dr. Rehan Quadri discusses Treating Clot in Transit on the BackTable 289 Podcast

Dr. Rehan Quadri

Dr. Rehan Quadri is a practicing interventional radiologist and an Assistant Professor in the Vascular Interventional Radiology division of the UT Southwestern.

Dr. Michael Barraza discusses Treating Clot in Transit on the BackTable 289 Podcast

Dr. Michael Barraza

Dr. Michael Barraza is a practicing interventional radiologist (and all around great guy) with Radiology Associates in Baton Rouge, LA.

Show Notes

We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome.

Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures.

He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus.

Resources

Inari Triever24 with FLEX Technology:
https://www.inarimedical.com/flowtriever/

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.

backtable-earn-free-cme.jpg
Become a BackTable Sponsor

Up Next

Código TEP: ¿Lo Hacemos Posible? con Dr. Sara Lojo Lendoiro, Dr. Juan Jose Ciampi Dopazo y Dr. Pilar Bayona Molano on the BackTable VI Podcast)
When that First Physician Job Isn't a Good Fit with Dr. Michael Barraza and Dr. Aaron Fritts on the BackTable VI Podcast)
Minimizing Complications for Lung Biopsies with Dr. Robert Suh on the BackTable VI Podcast)

Articles

Topics

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.

bottom of page