The primary objective of this clinical investigation is to evaluate the safety and effectiveness of the Cleaner Vac® Thrombectomy System for the treatment of thrombus in patients with lower extremity proximal deep vein thrombosis (DVT). This prospective, multi-center, open-label study will assess clinical outcomes, device performance, and procedural success in a single DVT study cohort.

Inclusion Criteria:

Participants must meet all the following criteria to be eligible for the study:

1. At least 18 years of age at the time of consent.

2. Undergo frontline (primary) treatment with Cleaner Vac® Thrombectomy System in the peripheral venous vasculature and have at least one component introduced into the body.

3. Written informed consent obtained through the IRB-approved ICF.

   For the DVT cohort, participants must meet all criteria above and below to be eligible for the study:

4. Present with unilateral or bilateral lower extremity DVT involving at least one of the following veins:

   1. Femoral-popliteal vein
   2. Common femoral vein
   3. Iliac vein
   4. Inferior Vena Cava (IVC)

5. DVT diagnosis confirmed by imaging within 14 days of the index procedure.

6. Symptomatic DVT with onset within 6 weeks of enrollment.

Exclusion Criteria:

Subjects will be excluded from the study if any of the following criteria are met:

1. Contraindication to systemic or therapeutic doses of anticoagulants.

2. Contraindication to iodinated contrast that cannot be adequately premedicated.

3. Life expectancy less than 1 year due to advanced malignancy, as determined by the investigator at the time of enrollment

4. Patients that are pregnant.

5. Known coagulation disorders both acquired (Heparin Induced Thrombocytopenia, etc.) or genetic (e.g., Factor V Leiden, etc.), thrombophilia, or hypercoagulable states that, in the opinion of the Investigator, cannot be medically managed throughout the study period.

6. Treatment of target venous segment with thrombolytics within previous 14 days of the index procedure.

7. Known congenital anatomic anomalies of the inferior vena cava (IVC) or iliac veins.

8. Known history of a Patent Foramen Ovale (PFO).

9. Hemoglobin < 8.0 g/dL, INR > 2.0 before warfarin was started, or platelets < 50,000/µl which cannot be corrected prior to enrollment.

10. Severe renal impairment (estimated GFR < 30 ml/min) in patients who are not yet on dialysis. Patients with GFR <30 ml/min who are already on dialysis can be enrolled.

11. Patients with intermediate-high risk or high-risk pulmonary embolism (PE) defined as follows:

    1. High-risk PE: Presence of hemodynamic instability, including cardiac arrest, obstructive shock (systolic blood pressure <90 mmHg or need for vasopressors with signs of end-organ hypoperfusion), or persistent hypotension (systolic BP <90 mmHg or a drop ≥40 mmHg for >15 minutes not due to other causes)
    2. Intermediate-high-risk PE: Hemodynamically stable patients with both right ventricular (RV) dysfunction (on echocardiography or CT) and elevated cardiac biomarkers (e.g., troponin).

12. Complete infrarenal IVC occlusion.

13. Chronic non-ambulatory status.

14. Current enrollment in another investigational device or drug study that may confound the results of this study. Studies requiring extended follow-up for products that were investigational but have since become commercially available are not considered investigational studies.

The study will enroll up to 185 adult participants undergoing percutaneous mechanical thrombectomy using the Cleaner Vac® Thrombectomy System for the treatment of thrombus in the peripheral venous vasculature.

Participants must be at least 18 years old and undergoing frontline treatment with the Cleaner Vac® device. The DVT subgroup must have symptomatic, imaging-confirmed DVT involving the femoral-popliteal, common femoral, iliac veins, or inferior vena cava (IVC), with symptom onset within 6 weeks and imaging confirmation within 14 days of the index procedure.

The study population is intended to reflect a real-world, all-comers cohort treated across up to 50 investigational sites in the United States.