Angel(®) Catheter use for pulmonary embolism prophylaxis in a polytrauma patient.

Abstract

To describe the successful, clinical use of the Angel(®) Catheter, a device used for the prevention of pulmonary embolism (PE) and central venous access in a critically ill, multi-trauma patient. Authors report the case of a 35-year-old man, in critical condition with multiple trauma injuries sustained from a fall, who was admitted to the Department of Rescue Medicine and Multiorgan Trauma in Krakow, Poland. Anticoagulation was interrupted due to the risk of intraoperative bleeding. Due to the continued presence of multiple VTE risk factors, the Angel(®) Catheter was placed at the bedside for the prevention of PE. At the time of removal, a CT scan demonstrated a filling defect, consistent with a fine emboli caught inside the filter. After removal, thrombus was found lodged in the tip of the catheter filter. The Angel(®) Catheter protected this critically ill, multi-trauma patient from PE at a time when current methods otherwise used for the prevention of venous thromboembolism (VTE), specifically antithrombotic pharmacologic agents and mechanical compression, were contraindicated due to the patient's complex clinical condition. Unlike other invasive techniques used for the prevention of PE, the Angel(®) Catheter also provided the convenience and expedience of bedside placement, eliminating the mandatory involvement of interventional radiologists or vascular surgeons, the need for specialised equipment, and movement of the patient which delay the procedure, increasing the risk of thromboembolic events.