**6. Pure mechanical devices**

These devices require no thrombolytic agent to be infused into the vessel. The devices are the Possis angiojet catheter, Spectranectics laser catheter and Pronto extraction catheter. The Possis system uses saline jet through its distal side holes to create a Bernoulli effect thereby removing clot without need for drug therapy. (Fig 7) The Spectranectic device uses laser technology to vaporize the clot and thereby clear the vessel of clot quickly without chance of distal embolic phenomenon. They also come in various sizes for different vessel territories. This device can also be used as an outpatient without need for overnight stay.

A) B)

C) Fig. 6. 61 y/o male with chronic pancreatitis with portal vein thrombosis A) Extensive portal vein thrombosis as seen on this transhepatic portogram B) Power pulse spray possis angiojet

These devices require no thrombolytic agent to be infused into the vessel. The devices are the Possis angiojet catheter, Spectranectics laser catheter and Pronto extraction catheter. The Possis system uses saline jet through its distal side holes to create a Bernoulli effect thereby removing clot without need for drug therapy. (Fig 7) The Spectranectic device uses laser technology to vaporize the clot and thereby clear the vessel of clot quickly without chance of distal embolic phenomenon. They also come in various sizes for different vessel territories.

and TPA thrombolysis of the portal vein C) Improved patency of portal vein

This device can also be used as an outpatient without need for overnight stay.

**6. Pure mechanical devices** 

The Pronto catheter (Pronto .035 extraction catheter, Vascular Solutions, Inc., Minneapolis, MN) is the newest pure mechanical device. Previously, developed from coronary interventions, it is now made for venous interventions. Pure aspiration catheters with large 8 French end hole-guiding catheters are used for cases with large clot burden such as massive pulmonary embolism and extensive deep venous thrombosis.

Fig. 7. 31 y/o body building male with dominant right arm swelling and pain c/w Paget Schroetter syndrome A) Possis angiojet pure thrombectomy device cleared clot from subclavian vein B) Uncovered focal irregular stenosis in subclavian vein which is worse with adduction arm motion C) Balloon Venoplasty of right subclavian vein D) Patent right subclavian vein with all degrees of motion the right arm on final images
