Description

From Which Medical Device

This simple device allows large bore aspiration of thrombus.

I have used this successfully for massive pulmonary embolism with great success.

The aspiration catheter itself is often enough, but you can also use the Flowtriever discs which are a little like an amplatzer plug that expand in the thrombus allwing it to be withdrawn into the catheter.

There are similarities in its use for PE with Penumbra's Indifo/Lighning devices, but no direct comparison.

  • Direct Comparisons: No head-to-head RCTs compare FlowTriever to Indigo/Lightning or standard care, unlike Penumbra’s ongoing efforts (e.g., STORM-PE, paused). Efficacy claims rely on surrogate markers (RV/LV, mPAP) rather than long-term outcomes.
  • Venous Data: FlowTriever’s venous efficacy is understudied versus ClotTriever or Indigo, limiting direct parallels to Penumbra’s venous applications.
  • Sample Size: FLARE (106) and EXTRACT-PE (119) are modest; FLASH and CLOUT scale up but lack controls.

In summary

The FlowTriever has similar data to Penumbra’s Indigo/Lightning systems for PE, showing efficacy in RV/LV reduction (25–38%), hemodynamic improvement, and low complication rates (1.8–3.8%), backed by FLARE, FLASH, and FLAME. Its venous efficacy is less documented but promising in case reports, akin to Lightning’s anecdotal venous success. Both systems offer efficient, thrombolytic-free clot removal, with FlowTriever’s mechanical retrieval adding a unique edge. However, larger comparative trials are needed to definitively rank their performance. The data aligns closely in scope and outcomes, tailored to their respective designs and indications.

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