The built-in microprocessor features a proprietary thrombus removal algorithm that automatically controls a valve in the tubing to provide continuous or intermittent aspiration. Sista A. Indigo aspiration system for acute pulmonary embolism. INDIGO CAT RX Aspiration Catheters and INDIGO SEPARATOR 4 Indication for Use As part of the INDIGO Aspiration System, the INDIGO CAT RX Aspiration Catheters and INDIGO SEPARATOR 4 are indicated for the removal of fresh, soft emboli and thrombi from vessels in the coronary and peripheral vasculature. Jawairia Sahar K. Mirza, MBBS Figure 2. Available in a selection of sizes, the CAT family can provide access to distal peripheral vessels of the upper and lower extremities, including below the knee. The Penumbra CAT RX catheter was used in a total of 34 patients, with 71% STEMI, 23% NSTEMI, 3% UA, and 3% new onset heart failure. The Penumbra ENGINE addresses the limitations of traditional treatment options by providing sustained mechanical power aspiration for the duration of the procedure to help maximize efficiency of thrombus removal. INDIGO Aspiration Catheters and Separators: As part of the INDIGO Aspiration System, the INDIGO Aspiration Catheters and Separators are indicated for the removal of fresh, soft emboli and thrombi from vessels of the peripheral arterial and venous systems, and for the treatment of pulmonary embolism. Mechanical Aspiration Thrombectomy Using the Penumbra CAT RX - PubMed Warnings Do not use the INDIGO Aspiration System with a pump other than a Penumbra Aspiration Pump. Possible complications include, but are not limited to, the following: allergic reaction and anaphylaxis from contrast media; acute occlusion; air embolism; arrhythmia; arteriovenous fistula; cardiac injury; cardio-respiratory arrest; death; device malfunction; distal embolization; emboli; excessive blood loss; false aneurysm formation; hematoma or hemorrhage at access site; inability to completely remove thrombus; infection; hemorrhage; ischemia; kidney damage from contrast media; neurological deficits including stroke; vessel spasm, thrombosis, dissection, or perforation; intimal disruption; myocardial infarction; emergent surgery; fibrillation; hypotension; hemoptysis; respiratory failure; thromboembolic events. Lightning 12 and Lightning 8 expand the already broad offering of CAT8, CATD, CAT6, CAT5, and CAT3 and are paired with Penumbra ENGINE, the company's proprietary continuous, mechanical vacuum . These types of burns heal withing 5 or 6 days without permanent scarring. Warnings Penumbra Announces U.S. Commercial Availability of INDIGO System As part of the INDIGO Aspiration System, the INDIGO Aspiration Catheters and Separators are indicated for the removal of fresh, soft emboli and thrombi from vessels of the peripheral arterial and venous systems, and for the treatment of pulmonary embolism. Presented at: Vascular InterVentional Advances (VIVA); November 47, 2019; Las Vegas, Nevada. 3D, 3D Revascularization Device, ACE, Artemis, BENCHMARK, CAT, Indigo, LANTERN, Lightning, MAX, Neuron, Neuron MAX, Penumbra Coil 400, Penumbra ENGINE, Penumbra P logos, Penumbra System, Penumbra SMART COIL, POD, PX SLIM, Ruby, Select, Separator, Velocity, and WAVE are all registered trademarks or trademarks of Penumbra, Inc. in the USA and other countries. Penumbra Aspiration Pump: The Penumbra Aspiration Pump is indicated as a vacuum source for Penumbra Aspiration Systems. Worcester, Massachusetts o The Penumbra Indigo System Separator is intended for use with our Indigo System's family of catheters to enable the removal of a wide range of thrombus. With a maximised inner diameter of 0.08 (2.1 mm) and a 7 French (2.3 mm) outer diameter, CAT7 is 93% the size of CAT8, now with a lower profile. Do not resterilize or reuse. When performing aspiration, ensure that the INDIGO Aspiration Tubing is open for only the minimum time needed to remove the thrombus. The newest indication for the Indigo System is the treatment of pulmonary embolism; this indication comes on the heels of the promising results of the EXTRACT-PE trial. The Penumbra Indigo System Separator is intended for use with our Indigo Systems CAT family of catheters to enable the removal of a wide range of thrombus. Initial angiogram of the right pulmonary artery showing pulmonary embolism. After one pass with CAT RX, the high thrombus burden was removed, resulting in TIMI 3 flow. Worcester, Massachusetts Penumbra introduced the Indigo System CAT RX in 2017 for the removal of fresh, soft emboli and thrombi from the . Do not use kinked or damaged devices. Her heart rate was 110 beats per minute, elevated troponin levels at 4.5 ng/mL, and elevated brain natriuretic peptide at 1,164 pg/mL. Figure 3. Two passes of CAT RX with the Penumbra ENGINE resulted in TIMI 3 flow restoration and retrieval of the distal emboli from the PDA (Figure 3). Penumbra CAT8XTORQ115 CAT8 Indigo System Aspiration Catheter 8F Item Past Expiration. Use the INDIGO Aspiration System in conjunction with fluoroscopic visualization. Contraindications There are no contraindications. The device is intended for single use only. Excessive aspiration or failure to close the INDIGO Aspiration Tubing when aspiration is complete is not recommended. 3. Figure 1. LIGHTNING Aspiration Tubing is a sterile aspiration tubing component of the INDIGO Aspiration System and is intended to serve as a conduit to assist in thrombus removal and restoration of blood flow in the peripheral vasculature and for the treatment of pulmonary embolism. The Indigo System CAT8 catheter comes in three different tip designsstraight, 45, 90which allows a wide range of rotation. The combination of computer-aided aspiration and large-lumen catheter engineering form Lightning 7 and Lightning 12: the latest generation in clot removal technology. Penumbra's high-performance aspiration catheters. 22. PDF May 15, 2018 - Food And Drug Administration Thrombectomy & Embolization | Vascular Medical Devices - Penumbra Inc Do not use open or damaged packages. The means of mains disconnect is to remove the power cord. 1. Precautions Applicant. A minimally-invasive device, Indigo enables the restoration of blood flow in such cases as acute limb ischemia and venous thrombus. Indication For Use Presented at: American College of Cardiologys 68th Annual Scientific Session; March 1618, 2019; New Orleans, LA. To avoid the risk of electrical shock, this equipment must only be connected to a supply mains with protective earth. This allowed prompt treatment of patients with minimal intensive care unit days and early discharge from the hospital. Only use replacement fuse with correct rating (see Table 1 for fuse rating). The CAT8 is indicated for removal of emboli and thrombi from the peripheral . Director of Cardiac & Peripheral Cath Lab Use of LIGHTNING Aspiration Tubing adjacent to other equipment should be avoided because it could result in improper operation. Otherwise, this could result in degradation of the performance of this equipment. The CAT family of catheters is the foundation of Penumbra's Indigo system. INDIGO Aspiration Tubing: As part of the INDIGO Aspiration System, the INDIGO Sterile Aspiration Tubing is indicated to connect the INDIGO CAT RX Aspiration Catheters to the Penumbra Aspiration Pump. The INDIGO Aspiration System should only be used by physicians who have received appropriate training in interventional techniques. Not for use in the coronaries or the neurovasculature. Use prior to the Use By date. Initial experience with a mechanical aspiration catheter for thrombus removal during percutaneous intervention: a multicenter retrospective case series. The initial angiogram confirmed an occlusion with extensive thrombus burden of a dominant left circumflex artery and TIMI 0 flow (Figure 1). Contraindications The INDIGO Aspiration System is contraindicated in: The removal of fibrous, adherent or calcified material (e.g. With reperfusion to the distal vasculature and clear visualization of the underlying stenosis, a 3.5-mm stent was placed. Disclosures: Consultant to Penumbra, Inc. A 92-year-old man with a history of coronary artery disease (treated previously with coronary artery bypass graft) and severe aortic stenosis (treated previously with transcatheter aortic valve replacement) presented to the ED with chest pain. The atraumatic tip and small catheter French size of the CAT8 device allows for easy tracking and maneuvering through the vasculature and selective debulking of thrombus from lobar branches of the pulmonary arterial tree. The Indigo System CAT3, CAT5, CAT6, CAT8, CATD, and CAT7D are engineered to be robust, trackable, atraumatic, and well suited for the peripheral anatomy. Possible complications include, but are not limited to, the following: Use prior to the Use By date. Contraindications There are no known contraindications. The INDIGO Aspiration Tubing is intended to connect the INDIGO Aspiration Catheters to the Penumbra Aspiration Pump. Jolly SS, Cairns JA, Yusuf S, et al. This website is intended for US audience only. Do not use open or damaged packages. Because the patient was not a candidate for thrombolysis, the decision was made to intervene with the Indigo System CAT8XTORQ115 and SEP 8, which were advanced sequentially into the right then left pulmonary artery. The Penumbra P logos, 3D, 3D Revascularization Device, ACE, BENCHMARK, CAT, Indigo, LANTERN, MAX, Neuron, Neuron MAX, Penumbra ENGINE, Penumbra JET, Penumbra System, Penumbra SMART COIL, POD, Ruby, Separator, Velocity, and WAVE are registered trademarks or trademarks of Penumbra, Inc. in the USA and other countries. Excessive aspiration or failure to close the INDIGO Aspiration Tubing when aspiration is complete is not recommended. After just one pass with CAT RX and 20 seconds of aspiration, the thrombus was removed. The Indigo system CAT3, CAT5, CAT6, CAT8 and CATD are engineered to be robust, trackable, atraumatic and well suited for the peripheral anatomy. Director of Cardiac Catheterization Lab, PERT & Structural Heart Reuse may result in canister cracking or vacuum filter blockages, which may result in the inability to aspirate. Penumbra CAT8XTORQ115 CAT8 Indigo System Aspiration Catheter 8F Item Past Expiration +1(833)330-3033. If such use is necessary, this equipment and the other equipment should be observed to verify that they are operating normally. Indication For Use Copyright 2023 Penumbra, Inc. All rights reserved. Throughout each case, Lightning provides procedural feedback via audio visual cues. The pain became more intense and constant, so he presented to the ED. Since the initial launch of the Indigo System, catheter technology as well as techniques have advanced. The Indigo System CAT3, CAT5, CAT6, CAT8 and CATD ?are engineered to be robust, durable, and trackable for use in the peripheral anatomy. Potential Adverse Events Available in a selection of sizes, the CAT family can provide access to distal peripheral vessels of the upper and . System Chair, Clinical Research Mechanical power aspiration with a continuous vacuum source and large lumen aspiration catheter was first introduced in the neurovascular space when Penumbra revolutionized thrombus removal for acute ischemic stroke patients. If repositioning of the INDIGO CAT RX Aspiration Catheter is necessary during the revascularization procedure, such repositioning should be performed over an appropriate guidewire using standard guidewire techniques. Disclosures: Consultant to Penumbra, Inc. A 65-year-old man presented emergently with an inferior wall MI. The Indigo Aspiration System is intended for the removal of fresh, soft emboli and thrombi from vessels of the peripheral arterial and venous systems and certain central circulatory system conditions such as pulmonary emboli using continuous aspiration. Mechanical Thrombectomy. Penumbras IndigoAspiration System can be used to remove emboli and thrombi from vessels of the peripheral arterial and venous systems, and for treatment of pulmonary embolism. The Penumbra IndigoSystem Separatoris intended for use with our Indigo Systems CATfamily of catheters to enable the removal of a wide range of thrombus. Do not use the INDIGO Aspiration System with a pump other than the Penumbra Aspiration Pump. Giri J, Sista AK, Weinberg J, et al. Penumbra Indigo System | Vascular Thrombectomy gtag('config', 'UA-18982160-1'); Penumbra Inc .cls-1{fill:#a6a699;}.cls-2{fill:#b5121b;}.cls-3{isolation:isolate;fill:url(#linear-gradient);}. sjaymathewsmd@gmail.com The Indigo Separator 4 is not intended for use as a guidewire. Precautions The safety and effectiveness of this device for use in the treatment of ST-Elevation Myocardial Infarction (STEMI) has not been established. Copyright 2023 Penumbra, Inc. All rights reserved. Copyright 2022 Penumbra, Inc. All rights reserved. chronic clot, atherosclerotic plaque) The cerebral vasculature Warnings The INDIGO Aspiration System should only be used by physicians who have received appropriate training in interventional techniques. Warnings The INDIGO Aspiration System should only be used by physicians who have received appropriate training in interventional techniques. The large aspiration lumen and highly trackable, low-profile design coupled with the power of the Penumbra ENGINE resulted in the successful removal of the emboli in one pass. Mathews SJ, Brown C, Kolski B, et al. Penumbra Aspiration Pump: INDIGO Aspiration System with LIGHTNING Aspiration Tubing Indication for Use Neuro | Penumbra, Inc. | Mechanical Thrombectomy & Embolization Do not advance, retract or use any component of the INDIGO System against resistance without careful assessment of the cause using fluoroscopy. Kingsport, Tennessee Manual aspiration suffers from diminished aspiration force as fluid fills in the syringe, potentially resulting in systemic embolization during catheter removal, as shown in the TOTAL trial published in 2015 (Figure 1).1 Subgroup analysis of patients with high thrombus burden was explored that highlighted the potential for improved outcomes. The Indigo Separator is advanced and retracted through the corresponding size Indigo catheter at the proximal margin of the primary occlusion to facilitate clearing of the thrombus from the catheter tip. The CAT family of catheters is the foundation of Penumbra's Indigo System. Excessive aspiration or failure to close the INDIGO Aspiration Tubing when aspiration is complete is not recommended. Initial angiogram showing high thrombus burden in the left circumflex artery. CAT7 and CAT12 are the next generation of the Indigo System catheters. Engineered with neuro-tracking technology, CAT RX is designed to navigate tortuous anatomy and track to distal coronary vasculature while maintaining sustained mechanical aspiration with the Penumbra ENGINE. Relying on a different mechanism of action, power aspiration with CAT RX and Penumbra ENGINE was able to extract the thrombus intact; thus restoring flow through the graft. Potential Adverse Events Possible complications include, but are not limited to, the following: allergic reaction and anaphylaxis from contrast media; acute occlusion; air embolism; arrhythmia/fibrillation; arteriovenous fistula; death; device malfunction; distal embolization; emergent surgery; false aneurysm formation; hematoma, hemorrhage, or blood loss at access site; hematoma, hemorrhage, or blood loss; hypotension; inability to completely remove thrombus or control blood flow; infection; ischemia; kidney damage from contrast media; myocardial infarction; neurological deficits including stroke; respiratory failure; thromboembolic events; vascular complications (including vessel spasm, thrombosis, intimal disruption, dissection, or perforation). For more information on the personal data that is collected by this website, please refer to Penumbras Privacy Notice. Caution: Prior to use, please refer to the Instructions for Use for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. PENUMBRA: CAT3 - westcmr.com 0, 24. CAT8 Indigo System Aspiration Catheter - TORQ - 8Fr x 85cm Conclusions: evaluation of the cat8 revealed that the device was fractured. 0, and 37. Ultrasound-guided access was obtained through the right femoral vein. Vascular Thrombectomy. Penumbra CAT8 KIT Indigo Aspiration Catheter 8 & Aspiration Tubing, XTorq Tip 115cm x 8F (NON-STERILE) Expired. The Indigo System CAT3, CAT5, CAT6, CAT8 and CATD ?are engineered to be robust, durable, and trackable for use in the peripheral anatomy. Figure 2. Return all damaged devices and packaging to the manufacturer/distributor. If repositioning of the INDIGO Aspiration Catheter is necessary during the revascularization procedure, such repositioning should be performed over an appropriate guidewire using standard catheter and guidewire techniques. Within 72 hours, repeat echocardiography showed RV/LV ratio improvement from 1.43 to 0.98. 3D, 3D Revascularization Device, ACE, Artemis, BENCHMARK, CAT, Indigo, LANTERN, Lightning, MAX, Neuron, Neuron MAX, Penumbra Coil 400, Penumbra ENGINE, Penumbra P logos, Penumbra System, Penumbra SMART COIL, POD, PX SLIM, Ruby, Select, Separator, Velocity, and WAVE are all registered trademarks or trademarks of Penumbra, Inc. in the USA and other countries. Related Items. Final angiogram after mechanical thrombectomy with CAT8 and SEP8. The initial angiogram revealed TIMI 0 flow in the proximal right coronary artery (RCA) due to plaque rupture. Do not use Indigo Separator 4 to macerate or retrieve thrombus distal to the catheter tip. How Penumbra's smart-sucking algorithms and catheters speed up clot Use prior to the Use By date. When performing aspiration, ensure that the INDIGO Aspiration Tubing valve is open for only the minimum time needed to remove thrombus. Do not use the INDIGO Aspiration System with a pump other than the Penumbra Aspiration Pump. INDIGO Aspiration Tubing: As part of the INDIGO Aspiration System, the INDIGO Sterile Aspiration Tubing is indicated to connect the INDIGO Aspiration Catheters to the Penumbra Aspiration Pump. The patient had a robust recovery and was discharged to her rehab facility on anticoagulation. We presented our initial experience at the American College of Cardiologys (ACC) 68th Annual Scientific Session, which showed promising results for mechanical power aspiration for thrombus removal during percutaneous intervention using CAT RX.3 This retrospective case series included 59 patients from four institutions around the United States. Do not resterilize or reuse. Do not use kinked or damaged devices. Final angiography was performed, showing complete resolution of the underlying lesion (Figure 2). The complaint indicated that the cat8 was kinked during the procedure. Utility of a power aspiration-based extraction technique as an initial and secondary approach in the treatment of peripheral arterial thromboembolism: results of the multicenter PRISM Trial. Penumbra's Newest Generation of Indigo Aspiration System Receives FDA The deliverability and continuous aspiration power were essential to achieving restoration of flow supporting a positive patient outcome to help heal this case of CLI. The Indigo System aspiration catheters are available in a range of lengths and diameters that, when connected to the Penumbra ENGINE pump, can atraumatically remove the thrombus present in various peripheral vascular beds. Precautions The device is intended or single use only. For more information on the personal data that is collected by this website, please refer to Penumbras Privacy Notice. Cedars Sinai Medical Center MAUDE Adverse Event Report: PENUMBRA, INC. INDIGO SYSTEM ASPIRATION INDIGO Aspiration Catheters and Separators: Potential Adverse Events Do not re-infuse blood or fluid from the canister back into the patient. Unrestrained torquing or forced insertion of the catheter or SEPARATOR against resistance may result in damage to the device or vessel. Lightning Aspiration Tubing has dual pressure sensors for real-time blood flow monitoring. Do not resterilize or reuse. If such use is necessary, LIGHTNING Aspiration Tubing and the other equipment should be observed to verify that they are functioning properly. UMassMemorial University Campus 5, 19. Use of this equipment adjacent to or stacked with other equipment should be avoided because it could result in improper operation. IN-DATE. Penumbra, CAT8XTORQ115, Penumbra CAT8 Indigo Aspiration Catheter, XTorq Previous Article, Single-Access Technique for Impella-Assisted High-Risk PCI. J Am Coll Cardiol. Common emitters (such as RFID emitters, security systems, diathermy equipment, and portable transmitters) should not be used in close proximity to the Penumbra ENGINE as they can interfere with and result in degradation of the performance of the equipment. In 2014, Penumbra broke into the peripheral thrombectomy space with the release of the first Indigo System catheters, the 5-F CAT5 catheter and the 3-F CAT3 catheter (Penumbra, Inc.). 1.10 Summary of Non-Clinical Data As required under Section 12, Part (a)(i)(3A) of the Safe Medical Devices Act of 1990, a Penumbra introduced the Ruby Coil in 2013, followed by the launch of PODin 2014 and Packing Coil in 2015. After one pass with mechanical thrombectomy using CAT RX, the thrombus was removed and flow was restored to the pedal arch via the plantar posterior tibial artery (Figure 2 and Figure 3). The Swan-Ganz catheter was exchanged over a long V18 wire. CAT RX is an essential tool in our percutaneous coronary armamentarium. Aspiration Tubing Intended Use INDIGO Aspiration System Intended Use Ballad CVA Heart & Vascular Institute J Vasc Interv Radiol. right-arrow Control angiography immediately after thrombectomy demonstrated restored patency . It will reduce the service life of the PENUMBRA ENGINE. Power aspiration with CAT RX and Penumbra ENGINE was started after wiring the dominant left circumflex artery. INDIGO SEPARATOR 4 is intended to be used with INDIGO CAT RX Aspiration Catheter to clear the distal end of the catheter lumen should it be blocked with thrombus. Do not use in an oxygen rich environment. INDIGO Aspiration Catheters and Separators: As part of the INDIGO Aspiration System, the INDIGO Aspiration Catheters and Separators are indicated for the removal of fresh, soft emboli and thrombi from vessels of the peripheral arterial and venous systems, and for the treatment of pulmonary embolism. Do not use in the presence of a flammable anesthetic mixture with air or nitrous oxide. Excessive aspiration or failure to close the INDIGO Aspiration Tubing when aspiration is complete is not recommended. Most recently, Penumbra launched LP System, including Ruby Coil LP and Packing Coil LP, which are low profile microcatheter compatible (.0165 - .021 ID). Potential Adverse Events Possible complications include, but are not limited to, the following: allergic reaction and anaphylaxis from contrast media; acute occlusion; air embolism; arrhythmia; arteriovenous fistula; cardiac injury; cardio-respiratory arrest; death; device malfunction; distal embolization; emboli; excessive blood loss; false aneurysm formation; hematoma or hemorrhage at access site; inability to completely remove thrombus; infection; hemorrhage; ischemia; kidney damage from contrast media; neurological deficits including stroke; vessel spasm, thrombosis, dissection, or perforation; intimal disruption; myocardial infarction; emergent surgery; fibrillation; hypotension; hemoptysis; respiratory failure; thromboembolic events. Possible complications include, but are not limited to, the following: allergic reaction and anaphylaxis from contrast media; acute occlusion; air embolism; arteriovenous fistula; death; device malfunction; distal embolization; emboli; false aneurysm formation; hematoma or hemorrhage at access site; inability to completely remove thrombus; infection; hemorrhage; ischemia; kidney damage from contrast media; neurological deficits including stroke; vessel spasm, thrombosis, dissection, or perforation; intimal disruption; myocardial infarction; emergent surgery; fibrillation; hypotension; respiratory failure; peripheral thromboembolic events. Penumbra ENGINE Intended Use Warnings Do not use the INDIGO Aspiration System with a pump other than a Penumbra Aspiration Pump. If the cause cannot be determined, withdraw the device or system as a unit. Distal emboli causing PDA occlusion after manual aspiration. Potential Adverse Events gtag('config', 'UA-18982160-1'); Penumbra Inc .cls-1{fill:#a6a699;}.cls-2{fill:#b5121b;}.cls-3{isolation:isolate;fill:url(#linear-gradient);}. Prior to use, please consult device labeling and instructions for use. 0 cm from the hub. INDIGO Aspiration Tubing: As part of the INDIGO Aspiration System, the INDIGO Sterile Aspiration Tubing is indicated to connect the INDIGO Aspiration Catheters to the Penumbra Aspiration Pump. The Indigo SystemCAT3, CAT5, CAT6, CAT8 and CATDare engineered to be robust, durable, and trackable for use in the peripheral anatomy. Potential Adverse Events window.dataLayer = window.dataLayer || []; Penumbra's LANTERN Delivery Microcatheter integrates a highly trackable 2.6 F microcatheter with a high-flow lumen to facilitate confident delivery of Ruby Coil, POD, and Packing Coil even in tortuous anatomy. Do not resterilize or reuse. The Indigo system CAT3, CAT5, CAT6, CAT8 and CATD are engineered to be robust, trackable, atraumatic and well suited for the peripheral anatomy. The INDIGO Aspiration System is intended to serve as a conduit to assist in thrombus removal and restoration of blood flow in the peripheral vasculature and for the treatment of pulmonary embolism. 0 cm from the distal tip. Warnings/Precautions Angiography of the posterior tibial artery revealed embolization to the heel resulting in no flow to the foot (Figure 1). This has allowed expansion of the use of the Indigo System in patients with coronary and peripheral vascular thrombotic occlusions. This warranted the need for further innovation in the field of acute coronary syndrome.2 The goal of the Indigo System CAT RX mechanical aspiration system powered by the Penumbra ENGINE is to provide sustained aspiration for the duration of the procedure with enhanced deliverability to navigate tortuous anatomy and track to the distal coronary vasculature. The Indigo Aspiration System is intended for the removal of fresh, soft emboli and thrombi from vessels of the peripheral arterial and venous systems and certain central circulatory system conditions such as pulmonary emboli using continuous aspiration. The cerebral vasculature The penumbra cat8 indigo system (cat8) was kinked approximately 4. Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. Copyright 2022 Penumbra, Inc. All rights reserved. Hemoglobin and hematorcrit levels should be monitored in patients with >700 mL blood loss from the clot aspiration procedure. Brian Kolski, MD
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