Introduction
In this insightful podcast episode, Dr. Karem Harth, a rising star in the field of venous disease, shares her experiences and expertise. Dr. Harth is the Director of the Center for Comprehensive Venous Care and the Co-Director of the Vascular Laboratories at University Hospitals in Cleveland Medical Center, Ohio. This article encapsulates her discussion on the latest technological advancements in venous disease treatment, specifically focusing on the new venous thrombectomy devices she has been exploring.
The Evolution of Venous Disease Treatment
Dr. Harth highlights the significant advancements in venous disease treatment over the last two decades. Historically, venous disease was often overlooked, especially in terms of reconstructive surgery for thrombotic and chronically occluded patients. However, the introduction of dedicated venous stenting around 2019 marked a major technological leap. Alongside stenting, multiple thrombectomy devices, both mechanical and suction-based, have emerged, offering new hope for patients with complex venous conditions.
Challenges and Solutions in Venous Stenting
Despite these advancements, challenges remain, particularly concerning stent failures. Dr. Harth discusses how anatomical and technical factors contribute to these failures. Proper stent sizing and placement are crucial, and failures often necessitate further intervention. Until recently, the options for recanalizing failed stents were limited to techniques like balloon angioplasty and suction thrombectomy. However, these methods often fell short of achieving a clear lumen.
Introduction to the RevCore Device
Dr. Harth introduces the Inari RevCore device, a groundbreaking tool designed specifically for venous stent thrombosis. This mechanical thrombectomy device addresses a range of thrombus chronicity and is adjustable to various lumen sizes, from 6 to 20 millimeters. The device’s handle allows for precise control, including torque advancement and expansion or contraction of the coring element, making it highly versatile for different procedural needs.
Case Study: Successful Use of the RevCore Device
To illustrate the device’s efficacy, Dr. Harth shares a case study of a 58-year-old male patient with a BMI of 40, who presented with a complex scenario involving superficial venous interventions and bilateral iliac stenting. The patient developed a left femoral vein DVT shortly after stenting, leading to significant complications. Traditional methods failed to adequately address the thrombosis, prompting Dr. Harth to employ the RevCore device.
Procedure and Outcomes
During the procedure, Dr. Harth used a combination of suction thrombectomy and the RevCore device to clear the thrombus and restore luminal patency. She emphasizes the importance of achieving a thrombus-free lumen before stent placement to ensure long-term success. The RevCore device’s ability to core out the thrombus significantly improved the patient’s condition, highlighting its potential as a game-changing tool in venous disease treatment.
Future Directions and Clinical Trials
Dr. Har is optimistic about the future of venous disease treatment, with ongoing advancements in dedicated venous devices. The RevCore device, while already showing promise, is currently under further evaluation in a registry study to ensure its safety and efficacy. These developments are crucial for improving patient outcomes and expanding the options available to treat complex venous conditions effectively.
Conclusion
Dr. Karem Harth’s insights into the evolving field of venous disease treatment underscore the importance of technological innovation. The introduction of devices like the RevCore represents a significant step forward, offering new solutions for patients with challenging venous conditions. As research continues and more data becomes available, these advancements are poised to transform the landscape of venous disease treatment, providing better outcomes and improved quality of life for patients.