Successful Debulking of Tricuspid Valve Vegetation in Infective Endocarditis Using the Latest Computer-Assisted Vacuum Thrombectomy Technology

The incidence of infective endocarditis (IE) has risen globally, with intravenous drug use contributing significantly to its increasing prevalence. IE can lead to severe complications, including embolic stroke, heart failure, and septic embolization, often resulting in high morbidity and mortality. While traditional treatment involves long-term antibiotics and surgery, some patients are poor surgical candidates and require alternative interventions. This case report presents a 50-year-old woman who developed methicillin-resistant <i>Staphylococcus aureus</i> tricuspid valve endocarditis complicated by persistent bacteremia and septic emboli. Due to her inoperability, she underwent successful percutaneous mechanical thrombectomy using the Penumbra Lightning Flash 2.0 system (Penumbra, Inc., Alameda, CA). The Penumbra Lightning Flash 2.0 device offers a less invasive, effective method for debulking endocarditis vegetations, reducing procedural risks, such as blood loss, and requiring fewer resources than other thrombectomy devices like the AngioVac system. This case demonstrates the potential of the Lightning Flash 2.0 as a safer, more accessible treatment option for patients with difficult-to-manage IE who cannot undergo surgery.