Table 4.
Percutaneous mechanical aspiration devices used in infective endocarditis.
| Device | Access | Cannula size | Length (cm) | Steerability | Aspiration mechanism | Aspiration power | Blood return | Advantages | Disadvantages |
|---|---|---|---|---|---|---|---|---|---|
| Large bore | |||||||||
| AngioVac F22 | 26F | 25F outer; 22F inner | 77.0 | ++ | V-V or V-A ECMO | +++ | Yes | Strong continuous aspiration forces; lower embolic risk; blood return | Vascular injury risk; structural damage risk; learning curve; cost and logistical challenges in setup; perfusionist availability |
| AngioVac F18 | 22F | 18F | 105.0 | ++ | V-V or V-A ECMO | +++ | Yes | ||
| AlphaVac F22 | 26F | 25F outer; 22F inner | 77.0 | ++ | Manual aspiration (handle) | ++ | No | Efficient setup; single access; strong pulling force | Vascular injury risk; intermittent aspiration; contact with vegetation (risk of embolization); no blood return mechanism |
| AlphaVac F18 | 22F | 18F | 105.0 | ++ | Manual aspiration (handle) | ++ | No | ||
| Inari FlowTriever | 22-26F | 20F or 24F outer and 20F T20 curve | 95.0 (20F and 24F) and 113.0 (T20 curve) | + | Manual aspiration (syringe) | +++ | Yes | Efficient setup; single access; strong pulling force; blood return | Vascular injury risk; structural damage risk; flow power not continuous |
| Small bore | |||||||||
| Penumbra Lightning 12 | 12F steerable sheath | 12F | 115.0 | +++ | Engine mediated | + | No | Efficient setup; less risk of vascular injury; less risk of structural damage; steerability; maneuverability | Modest aspiration forces; need for contact with vegetation (risk of embolization); no blood return mechanism |