Peripheral Vascular Disease (PVD)
PVD affects more than 20% of the population over 70, approximately 10 million people annually.
- Artherosclerosis:
- Plaque integrates into the vessel wall
- Often calcified (hard)
- Plaque is site specific (not mobile)
- Treatment is re-opening using compression or excision and sometimes stenting.
- Thrombosis:
- Vessel blockage
- Composed of fibrin and erythrocytes
- Sites vary as thrombi may be mobile (may migrate to lungs).
- Conventional treatment with anticoagulants prevents new clots forming, but does not address existing clot burden.
- Clot removal needed to restore patency.
PVD Treatment Dilemma
When left behind by conservative or inefficient treatment modalities, residual thrombus can result in long-term complications and diminished quality of life after an acute PE or DVT event.
Although many modalities attempt to remove thrombus burden, mechanical and aspiration thrombectomy are some of the newest and most promising because they avoid the usage of thrombolytics and associated bleeding risks. Despite advantages, one issue that continues to plague these devices is blood loss. The benefits of removing thrombus are clear, but there exists a trade-off between capturing all the thrombus and aspirating too much blood. The need to minimize blood loss during mechanical thrombectomy procedures forces physicians to end cases before all thrombus has been removed.