Percutaneous management of post-thrombotic syndrome: Early experience with a novel thrombectomy catheter designed to address chronic venous occlusions

Background:Post-thrombotic syndrome (PTS) is a chronic sequela of deep vein thrombosis (DVT), often associated with significant morbidity and limited treatment options in advanced cases.The VenaCore thrombectomy catheter (Inari Medical, Irvine California) has been developed to address chronic venous occlusions without the need for stenting. Methods:This retrospective single-centre review examined the first eight consecutive patients with PTS treated with the VenaCore catheter at our institution between September and December 2024.Clinical data, procedural details, technical success, safety outcomes, and 30-day follow-up imaging and symptom assessment (Villalta score) were evaluated.A comprehensive description of our endovascular approach and device technique is provided. Results:Eight patients (4 female, 4 male; median age 39 years) were treated.Median time since DVT diagnosis was 2 years (range: 6 months to 20 years).All patients had moderate to severe PTS symptoms.Technical success was achieved in 7 of 8 patients (88%).Median length of occlusion crossed was 20 cm.A mix of both iliofemoral and femoropopliteal occlusions were treated(4:4) . J o u r n a l P r e -p r o o fMedian VenaCore device time was 10 minutes, with luminal gain observed in all cases.One vessel rupture was encountered (managed successfully).At 30-day follow-up, treated segments remained patent in 6 of 7 successfully recanalized patients (86%).Improvement in symptoms was reported by these 6 patients, with a mean reduction in Villalta score of 4.8(IQR 4-5) observed. Conclusion:In our initial experience, the VenaCore thrombectomy catheter demonstrated promising technical performance in improving luminal gain and symptom relief in patients with PTS, with an acceptable safety profile.Further studies are warranted to assess long-term patency and clinical durability.