Instant unblocking, immediate effect—application of SWAM aspiration thrombectomy in lower extremity vascular diseases

Background: Venous Thromboembolism (VTE), encompassing Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), is the third most common cardiovascular disease globally. In China, Acute Pulmonary Embolism (APE) carries a high mortality rate, underscoring the need for rapid and effective treatment modalities. While anticoagulation remains a foundational therapy, treatment options like Catheter-Directed Thrombolysis (CDT) and surgical thrombectomy are limited by bleeding risks, procedural complexity, and extended procedure times. Percutaneous Mechanical Thrombectomy (PMT) has emerged as a promising alternative, with meta-analyses demonstrating superior patency and safety compared to CDT alone.

Objective: To evaluate the efficacy and safety of the SWAM (Separated Wire Aspiration Mechanical) aspiration thrombectomy system as an innovative PMT solution for lower extremity vascular diseases.

Methods and Technology: This presentation reviews the principles of the Zhongtian Peripheral Debulking Innovative Solution (SWAM Aspiration), which integrates the Tianhang™ M Aspiration Catheter and the Tianji™ M Thrombus Separator. The system employs continuous, high-negative-pressure aspiration (-28 inHg) through a large-lumen catheter with a 9-segment transition design for optimal support and kink resistance. A key differentiator is the synchronous mechanical fragmentation of thrombus by the internal separator, which prevents catheter occlusion, enhances aspiration efficiency for large-volume thrombi, and eliminates the need for repeated catheter exchanges or prolonged thrombolytic therapy.

Results: Comparative analysis with existing PMT devices (e.g., AngioJet, Indigo) highlights the advantages of the SWAM system. These include a high aspiration success rate without mandatory thrombolysis, a low risk of vascular injury due to an atraumatic tip, the ability to treat below-the-knee (BTK) lesions, a significantly lower risk of distal embolism, and a short operation time (typically 20-30 minutes). The system's design ensures efficient, 360° aspiration with minimal tube blockage.

Conclusion: The SWAM Aspiration Thrombectomy system represents a significant advancement in PMT technology. By combining continuous negative pressure aspiration with synchronous mechanical thrombus fragmentation, it offers a rapid, effective, and safe solution for vessel recanalization in lower extremity VTE. Its ability to achieve "instant unblocking" with an "immediate effect," while mitigating bleeding risks and procedural complexity, positions it as a superior therapeutic option for improving patient outcomes in peripheral vascular diseases.

Dr. Zhang Tianhua is a vascular surgeon specializing in vascular disease research and outbreak response. He holds a MD in Surgery from Harbin Medical University. Chief Physician, and Master's SupervisorVisiting Scholar at Teikyo University and the University of Tokyo, JapanVisiting Scholar at Royal Perth Hospital, Australia Published over 40 national-level academic papers, including 13 SCI papers (all as first author or corresponding author)Published four national-level books (two as chief editor and two as associate editor)Two national patent inventions.