Extensive suprarenal thrombosis extending to the iliac veins treated using the AngioVac system. (a) Coronal contrast enhanced CT demonstrating the suprarenal IVC thrombosis. (b) Venogram showing the IVC thrombosis. (c) AngioVac system within the IVC engaging the IVC thrombus (d). (e) Rotational thrombectomy system is used while the AngioVac system is engaged. (f) Mechanical thrombectomy using angioplasty balloons. (g) Postprocedure venogram reveals patent infrarenal IVC and iliac veins with residual chronic thrombosis. ((h) and (i)) Aspirated predominantly chronic thrombi are shown.