RIGHT ATRIAL THROMBI - PERCUTANEOUS MECHANICAL THROMBECTOMY

The current therapeutic options for right atrial thrombi-surgical embo lectomy and thrombolysis-are associated with high mortality and such p atients often have contraindications to these therapeutic options, The purpose of this study was to evaluate the feasibility of endovascular right atrial embolectomy, Two patients with contraindications to thro mbolysis and surgery were treated by a femoral approach. A catheter wa s placed in the right atrium, under fluoroscopic control, and a basket device was used to trap the thrombus. The location and extent of the thrombus was established before the procedure by transesophageal echoc ardiography (TEE) and the procedure was performed with TEE and fluoros copy. Thrombi were withdrawn in the basket into the inferior vena cava (IVC) and a filter was inserted by a jugular approach and positioned in the IVC, just above the thrombi, The basket was removed leaving the thrombus below the filter. One patient died immediately after the pro cedure. In conclusion, endovascular extraction of right atrial thrombi may represent a potential therapeutic alternative, particularly in pa tients with contraindications to thrombolysis and surgery.