Computer-assisted vacuum thrombectomy using lightning 12 and lightning flash 16 in acute proximal lower extremity deep vein thrombosis

Objective To report a single-center experience using the Lightning 12 and Lightning Flash 16 computer-assisted vacuum thrombectomy (CAVT) Indigo System devices for acute proximal lower extremity deep vein thrombosis (DVT). Methods A retrospective review was conducted of all consecutive patients treated with CAVT for acute (<14 days) proximal lower extremity DVT between January 2023 and September 2024 at academic single center. The primary outcome was technical success, defined as >70% thrombus removal on final completion venography, assessed by at least two different operators. Results Twenty-four patients (median age 55.5 years; 58.3% female) with 29 affected limbs were included. Classical May-Thurner syndrome was present in 37.5%. Thrombosis involved the left iliofemoral segment in 44.8%, right iliofemoral in 31.0%, isolated common iliac vein in 6.8%, and inferior vena cava extension in 17.2%. Devices used included Lightning 12 (25.0%) and Lightning Flash 16 (75.0%). Iliac vein stents were placed in 82.8% of limbs. Median operative time was 120 min, blood loss 750 cc, and hospital stay 2 days. No intraoperative complications occurred. Two non-procedure-related deaths occurred within 30 days. Median follow-up was 9 months; three additional late deaths were unrelated to the procedure. The median Villalta score was 1, and VCSS was 1. No significant outcome differences were observed between the two device types. Conclusion The CAVT Indigo System appears to be a safe and effective treatment option for acute proximal lower extremity DVT, demonstrating high technical success and low complication rates.