a hand held motor powered device for percutaneous thrombolysis and evacuation of a clot from a clotted arterio - venous fistula is disclosed . the percutaneous thrombectomy device is provided with a plurality of nested coaxial lubricious catheters . the multi - functional thrombectomy device can simultaneously and sequentially degrade and evacuate a blood clot from a blood vessel by multiple modalities that combines to degrade the clot by mechanical agitation , fragmentation and disruption , by peri - thrombus delivery of enzymatic fluids , by irrigation with biocompatible fluids , and by balloon displacement . the thrombectomy device further provides for balloon containment and isolation of clot debris from the general circulation , thereby minimizing the risks to a patient of embolic sequelae . there is also provided an optional steering mechanism for controlled deflection of the working end of the device .