# DELTA-HF: thoracale-duct lymfedecongestie via eLym-systeem haalbaar bij acute hartfalen

*geplaatst 2026-05-10 · Hartfalen · European Journal of Heart Failure · doi 10.1093/ejhf/xuag157 · https://hartvaat.nl/2026/05/10/delta-hf-thoracale-duct-lymfedecongestie-via-elym-systeem-haalbaar-bij-acute-har/*

DELTA-HF — multicentrische, single-arm, fase-eerste-in-mens — testte het eLym-systeem bij 40 patiënten met acuut gedecompenseerd hartfalen (32,5% vrouw, 71±11 jaar, mediaan 2 opnames in voorgaande 6 maanden, allen op ≥80 mg furosemide-equivalent thuis). Een endoveneuze axiale pomp creëerde een laag-druk-zone bij de venous angle om lymfeafvloed via de ductus thoracicus te ondersteunen. Plaatsing slaagde bij alle 40 patiënten (therapieduur 23,1±7,3 uur). Gewicht daalde 3,6±2,4 kg tijdens behandeling en 6,8±3,4 kg tot ontslag. Mediane EVEREST-congestiescore zakte van 5 naar 0 bij ontslag en bleef stabiel tot 6 maanden (p<0,0001). Serumcreatinine bleef stabiel. 95% vrij van ernstige device- of procedure-gerelateerde events. Eén patiënt overleed aan een vaatcomplicatie met mediastinaal hematoom; één had inotropie nodig wegens hypotensie. Bij 6 maanden waren er drie hartfalenopnames bij twee patiënten en vijf sterftegevallen. Conclusie: lymfedecongestie via de venous angle is technisch haalbaar en lijkt veilig bij therapieresistente congestie. Veelbelovend, maar gerandomiseerde trials zijn nodig — de single-arm 6-maandsmortaliteit (12,5%) is in lijn met de hoog-risico populatie.

## English: 

DELTA-HF (n=40, single-arm, multicenter) tested the eLym System — an endovenous axial pump creating a reduced-pressure zone at the venous angle to support lymphatic drainage via the thoracic duct — in patients with acute decompensated HF refractory to oral diuretics. Deployment was 100% successful, weight loss 3.6 kg during therapy and 6.8 kg by discharge, congestion score from 5 to 0 (sustained at 6 months), creatinine stable. 95% freedom from device/procedure SAEs; one fatal vascular complication. Encouraging proof of concept in a difficult-to-decongest population; randomized trials warranted.

## Abstract (original, from the publication)

Background: Persistent congestion at discharge is associated with worse outcomes in acute decompensated heart failure (ADHF), with impaired lymphatic function contributing to difficult-to-target tissue and organ congestion. Methods: The safety and effectiveness of the eLym System in ADHF was evaluated in the multicenter, single-arm DELTA-HF trial. A localized reduced-pressure zone at the venous angle was created in 40 patients using an endovenous axial pump to support lymph drainage through the thoracic duct. Results: Forty patients with ADHF (32.5% female, 71±11 years) received therapy. Patients had a median of 2 hospitalizations in the prior 6 months and were on home daily loop diuretic dose equivalent to ≥80 mg furosemide. Device deployment was successful in all cases (therapy time: 23.1±7.3 hours). Weight decreased by 3.6±2.4 kg during eLym therapy and by 6.8±3.4 kg at discharge. Median modified EVEREST Clinical Congestion Score improved from 5.0 to 2.0 after treatment and to 0 by discharge, remaining stable through 6 months (p<0.0001). Serum creatinine remained stable acutely and through 6 months. Freedom from device- or procedure-related serious adverse events was 95%. One patient had a vascular complication causing mediastinal hematoma and death; another required inotropes due to hypotension. At 6 months, two patients experienced three HF hospitalizations and five patients died (four cardiovascular, one urosepsis). Conclusions: eLym therapy in ADHF appeared to be safe, with early data suggesting effective, durable decongestion and a low 6-month rehospitalization rate. Randomized controlled trials are warranted.

Auteurs: Jorge Nuche, María Dolores García-Cosío Carmena, Jan Biegus, Zviad Kereselidze, Archil Chukhrukidze, George Khabeishvili

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Bron: European Journal of Heart Failure, https://doi.org/10.1093/ejhf/xuag157. Bijgewerkt 2026-07-03T18:39:32Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.