3:45 PM Abstract No. 287 Results of Registry of AngioVac Procedures in Detail (RAPID): prospective multicenter real-world experience in 206 patients with 214 procedures

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, and right heart masses are significant causes of preventable death, affecting over 6 million people globally. Conventional management with anticoagulation can be augmented by thrombolytic or transcatheter therapies. The AngioVac Cannula and extracorporeal bypass circuit (AngioDynamics, Queensbury, NY) is a novel device for aspiration of thrombi and masses. The Registry of AngioVac Procedures in Detail (RAPID) is a multicenter prospective registry focused on the uses, efficacy and early complications of the AngioVac device. Over 40 months from March 2016 to August 2019 214, consecutive AngioVac procedures were performed in 206 patients. Data in electronic case report forms was entered locally into a secure online Redcap database. Typical indications for AngioVac included right heart masses (RHM), IVC thrombosis and pulmonary embolism (PE). Primary outcomes were procedural safety and success at clot removal, with multiple disease and procedure specific secondary outcomes. AngioVac procedures were performed for right heart masses in 104 cases (48.6%), DVT/Caval thromboembolism in 81 cases (37.9%) for catheter related thrombi in 24 (11.2%) and only 5 cases (2/3%) for PE. There were 2 non-procedure related deaths within 24hrs, and 1 procedure related death (0.43%). 63% of cases reported 100% right heart clot removal, 71% had 100% caval thrombus removal, with restoration of inline flow in 91%. The estimated blood loss (EBL) was less than 250 cc in 163 of 216 cases (76%). N = 55 (26%) underwent blood transfusion either intraoperatively or within the first 24 hours postoperatively, with 43/55 (95%) of transfusions being of 2 units red blood cells or less. The mean pre procedure hemoglobin was 10.3 mg/dL (SD 2.91) which decreased to 9.4 mg/dL (SD 2.65) at 24 hours, a mean decrease of 0.93 mg/dL. Use of the AngioVac device is safe and effective in removal of select right heart masses and caval thrombi, while use for PE is rare and efficacy could not be evaluated.