ADVERTORIAL
Argon is making clot removal easier and more efficient than ever with the new CLEANER Vac™ Thrombectomy System. CLEANER Vac, a large-bore, disposable aspiration system, puts the control in physician’s hands with simple, manually controlled aspiration that helps result in thorough and safe clot removal.
“We have seen an increase in cases of acute portal vein thrombus, both in the cirrhotic and non-cirrhotic populations,” said Benjamin J. May, MD, assistant professor of radiology at Weill Cornell Medicine. As larger-suction thrombectomy devices have become available, Dr. May says that IRs have become more likely to intervene because the larger-suction devices enhance their ability to clear the main clot.
The CLEANER Vac has several key features that physicians say set it apart, from its size to its suction system.
Physician control
The CLEANER Vac provides on-demand aspiration, controlled via a simple on/off switch lever for instant suction that puts the physician directly in control.
“With many devices, there’s a lag at some point in the aspiration process, whether it’s vacuum or syringe assisted, which results in a certain time period where you can’t control blood loss,” said Sabah Butty, MD, an interventional radiologist with Indiana University. “With the CLEANER Vac, the aspiration or vacuum is immediate, so you can be more targeted and remove maximum clot while minimizing the amount of blood loss. That’s an incredibly important feature when it comes to doing thrombectomies of the deep veins.”
In addition, the 400 ml aspiration cannister allows physicians to visualize real-time blood loss, and because the full system is battery-powered and sterile, both the suction cannister and device can be on the sterile table during the procedure.
Size
The CLEANER Vac aspiration catheter is 18 Fr and 115 cm long, which Dr. May calls “the sweet spot.”
“To me, 18 Fr is a good balance between being able to clear large volumes of clot, countered with the need for bigger sheaths and bigger access,” he said, adding that even when continuing the patient on blood thinners, his team has no issues closing up an 18 Fr sheath access.
The length also offers flexibility, according to Dr. Butty, who finds the 115 cm length ideal for his preferred method of vessel access.
“In general, I have abandoned the popliteal approach and whenever possible, and will come from a top-down approach, starting from the right internal jugular vein,” he said. From there, he will catheterize the popliteal veins, deep femoral veins and in some instances the internal iliac veins as necessary to debulk the thrombus material.
“With this approach, the length of the device is ideal,” he said.
“Efficient and Effective”
“When treating clot, we have to be creative about how to create efficiency during the procedure, and using adjunctive devices is part of that,” said Dr. Butty. “With the CLEANER Vac, you can combine techniques for clot preparation—simultaneously macerating the clot with the CLEANER wire and then aspirating with the CLEANER Vac.”
According to Dr. Butty, this approach helps to decrease the likelihood of embolization. In a recent case, he and his team ran the CLEANER Vac and CLEANER rotational wire through iliac stents that had been thrombosed for at least 2 weeks. With just a few passes of the devices, the imaging showed complete removal of the thrombus material and no clinical evidence of embolization.
“It’s extremely effective to be able to macerate and aspirate clot at the same time,” said Dr. May. “Not only does it help to make the intervention faster, but it also helps avoids situations like lollipopping which can happen with suction only. The combined effect helps get total clearance of acute clot.”
Conclusion
For a sustainable, simple solution that offers flexibility, user-control and thorough clot removal, Dr. Butty said he believes the CLEANER Vac’s immediate aspiration control sets this device apart in the market.
“The vacuum power is instantaneous, and as a result, you are able to be much more efficient,” he said. “You can get a generous amount of clot material out with very little blood loss—which results in better outcomes for the patient.”
Disclaimer: This article is sponsored by an SIR Corporate Partner and does not necessarily reflect the views or policies of SIR. SIR assumes no liability, legal, financial or otherwise, for the accuracy of information in this article or the manner in which it is used. The statements made in the column are not intended to set a standard of care and should not be treated as medical advice nor as a substitute for independent, professional judgment.
