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To demonstrate the safety and effectiveness of a computer-assisted large-bore thrombectomy (CA-LBT) device in aspiration thrombectomy for treatment of deep vein thrombosis (DVT). A single-institution retrospective review was performed to include 16 consecutive patients (median age, 51.1 years; range, 19–77 years; 5 men and 11 women) who underwent percutaneous thrombectomy using a 16-F CA-LBT device (Lightning Flash Aspiration System; Penumbra, Alameda, California) for DVT (12 iliofemoral occlusions with or without caval extension [75.0%], 3 axillosubclavian occlusions [18.8%], and 1 caval occlusion [6.3%]) between January 2023 and August 2023. Thrombectomy was performed via the popliteal (n = 10, 62.5%), femoral (n = 3, 18.8%), saphenous (n = 1, 6.3%), brachial (n = 1, 6.3%), and femoral and brachial (n = 1, 6.3%) veins, with a median fluoroscopy time of 17 minutes (range, 7.2–61 minutes) and contrast agent volume of 110 mL (range, 30–175 mL). Restoration of anterograde flow was achieved in all cases (100%, 16/16). Thirteen patients (81.2%) received venoplasty after thrombectomy for residual stenosis. Stents were placed in 7 patients (43.8%). With a median clinical follow-up of 77 days (range, 3–278 days), symptom improvement was achieved among 13 of 15 patients (86.7%) who initially presented with DVT-associated symptoms. Of 14 patients with imaging follow-up, patency was confirmed in 12 (85.7%). Of the 2 patients (14.3%) with complete thrombosis on follow-up imaging, one patient was successfully treated with repeated thrombectomy using CA-LBT technology and the other was treated with systemic anticoagulation. Aspiration thrombectomy with this 16-F CA-LBT device is a feasible option for treatment of proximal or large-volume DVT. [Display omitted] [ABSTRACT FROM AUTHOR]

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Medical professional liability (MPL) is becoming a substantial issue in interventional radiology (IR), with both impact on health care costs and negative psychological effects on physicians. MPL presents special challenges within IR because of the field's complex and innovative therapies that are provided to a diverse group of patients and complicated by the off-label use of devices and drugs that is pervasive in the field. This review discusses the principles and practices to avoid and manage MPLs that are specific to the field of IR. [ABSTRACT FROM AUTHOR]

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