The THRIVE study – which shows that computer-assisted vacuum thrombectomy (CAVT™) is associated with reduced related readmissions and complication rates in the management of lower extremity acute limb ischemia (ALI) when compared to surgical embolectomy – offers “compelling evidence that this is the right therapy for our patients,” says Charles Bailey, MD, medical director of limb preservation and peripheral arterial disease (PAD) at Emory University School of Medicine in Atlanta, in a video interview with Vascular Specialist at the 2025 Vascular Annual Meeting (VAM) in New Orleans (June 4–7).
Bailey had just delivered THRIVE data demonstrating that U.S. patients who underwent a CAVT procedure to manage lower extremity ALI had significantly shorter length of stays, higher discharge-to-home rates, reduced complications and fewer related readmissions compared to other modalities.
“If we have a therapy that can offer a patient a shorter length of stay, a greater likelihood that they are going to go home, and is associated with not only good, improved clinical outcomes, but a greater freedom from adverse events, greater freedom from complications or potentially readmission, we should embrace that therapy,” Bailey explains.
This video was sponsored by Penumbra.
As a retrospective study, the issue is always the intent to treat and selection bias. I would immediately assume the more profoundly ischemic limbs were more likely surgically approached. One way to control for this with acute limb ischemia is to use compartment syndrome as a denominator to reflect the severity and time course of the ischemic event (not to mention the class, such as Rutherford class 1-3). So I ask you, what percentage of open surgical and CAVT patients in your review ended up with 4 compartment fasciotomies at the time of or shortly after initial treatment? Of those patients who had such certain limb threatening ischemia, what were the outcomes of this sub-population? -Dr. Chris Bunch, Duluth MN