Six-month outcomes of mechanical thrombectomy for treating deep vein thrombosis: Analysis from the 500-patient CLOUT registry

Purpose:Mechanical thrombectomy for the treatment of deep vein thrombosis (DVT) is being increasingly utilized to reduce symptoms and prevent postthrombotic syndrome (PTS), but more data on clinical outcomes are needed. Mechanical thrombectomy was studied in the ClotTriever Outcomes (CLOUT) registry with 6-month full analysis outcomes reported herein. Materials and methods:The CLOUT registry is a prospective, all-comer study that enrolled 500 lower extremity DVT patients across 43 US sites treated with mechanical thrombectomy using the ClotTriever System. Core-lab assessed Marder scores and physician-assessed venous patency by duplex ultrasound, PTS assessment using Villalta score, venous symptom severity, pain, and quality of life scores through 6 months were analyzed. Adverse events were identified and independently adjudicated. Results:All-cause mortality at 30 days was 0.9%, and 8.6% of subjects experienced a serious adverse event (SAE) within the first 30 days, 1 of which (0.2%) was device related. SAE rethrombosis/residual thrombus incidence was 4.8% at 30 days and 8.0% at 6 months. Between baseline and 6 months, venous flow increased from 27.2% to 92.5% of limbs (P \u3c 0.0001), and venous compressibility improved from 28.0% to 91.8% (P \u3c 0.0001), while median Villalta scores improved from 9.0 at baseline to 1.0 at 6 months (P \u3c 0.0001). Significant improvements in venous symptom severity, pain, and quality of life were also demonstrated. Outcomes from iliofemoral and isolated femoral-popliteal segments showed similar improvements. Conclusion:Outcomes from the CLOUT study, a large prospective registry for DVT, indicate that mechanical thrombectomy is safe and demonstrates significant improvement in symptoms and health status through 6 months. Level of Evidence 3: Non-randomized controlled cohort/follow-up study

Quantification of variability in bedform geometry

We analyze the variability in bedform geometry in laboratory and field studies. Even under controlled steady flow conditions in laboratory flumes, bedforms are irregular in size, shape, and spacing, also in case of well-sorted sediment. Our purpose is to quantify the variability in bedform geometry. We use a bedform tracking tool to determine the geometric variables of the bedforms from measured bed elevation profiles. For each flume and field data set, we analyze variability in (1) bedform height, (2) bedform length, (3) crest elevation, (4) trough elevation, and (5) slope of the bedform lee face. Each of these stochastic variables is best described by a positively skewed probability density function such as the Weibull distribution. We find that, except for the lee face slope, the standard deviation of the geometric variable scales with its mean value as long as the ratio of width to hydraulic radius is sufficiently large. If the ratio of width to hydraulic radius is smaller than about ten, variability in bedform geometry is reduced. An exponential function is then proposed for the coefficients of variation of the five variables to get an estimate of variability in bedform geometry. We show that mean lee face slopes in flumes are significantly steeper than those in the field. The 95% and 98% values of the geometric variables appear to scale with their standard deviation. The above described simple relationships enable us to integrate variability in bedform geometry into engineering studies and models in a convenient way