Comparison of Low-Dose Catheter-Directed Thrombolysis with and without Pharmacomechanical Thrombectomy for Acute Lower Extremity Ischemia

Gandhi, Sagar S.; Ewing, Joseph A.; Cooper, Emily T.; Chaves, J. M.; Gray, Bruce H.

doi:10.1016/j.avsg.2017.07.008

Cited by 19 publications

(5 citation statements)

References 10 publications

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“…Therefore, mechanical thrombectomy and aspiration thrombectomy provide an additional endovascular recanalization technique that has been shown to have better technical success and limb salvage rates than thrombolysis. 6 , 7 In a prospective study, Gray et al 8 reports success removing thrombus from the SFA and popliteal artery segment and a reduction in the need for concomitant CDTT in 44 of 46 patients. Unlike other percutaneous thrombectomy methods such as Penumbra suction thrombectomy (Penumbra Inc), Pounce offers a distinct advantage by effectively addressing subacute and chronic clots, expanding its utility in a broader range of clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

Retrograde pedal access and percutaneous mechanical thrombectomy for salvage of an occluded vein bypass

Rice,

Darkwa,

Wang

2024

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

Retrograde pedal access and percutaneous mechanical thrombectomy for salvage of an occluded vein bypass

Rice,

Darkwa,

Wang

2024

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…It is recommended to rehydrate patients with isotonic saline during and after surgery and alkalize urine with sodium bicarbonate. AngioJet thrombus aspiration has been applied in different diseases, including acute thrombosis and stent thrombosis, and the success rate of effective intraoperative blood flow recovery is between 60% and 90%[ 22 ]. The PEARL clinical study reported the results of mechanical thrombolysis with rheological drugs in the treatment of acute lower extremity ischaemia.…”

Section: Discussionmentioning

confidence: 99%

Observation of the effect of angiojet to treat acute lower extremity arterial embolization

Meng¹,

Xie²,

Liu³

et al. 2023

World J Clin Cases

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BACKGROUND Through significant advances in the treatment of peripheral arterial occlusive disease, acute ischemia of the lower extremity is still associated with significant morbidity, limb threat and mortality. The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries. Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia. AIM To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization. METHODS Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected. Among them, the observation group (twenty-eight cases) had received angiojet thrombolysis, and the control group (thirty-four cases) had received femoral artery incision and thrombectomy. After thrombus clearance, significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation. When the thrombus removal was not satisfactory, catheter-directed thrombolysis was performed. The incidence of postoperative complications, recurrence rate and recovery of the two groups were compared. RESULTS There were no significant differences in postoperative recurrence (target vessel reconstruction rate), anklebrachial index and the incidence of postoperative complications between the two groups ( P > 0.05); there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups ( P < 0.05). CONCLUSION The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective, minimally invasive, quicker recovery after operation, less postoperative complications, which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions. If the thrombus removal is not satisfactory, the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used. Balloon dilation and stent implantation can be considered for obvious lumen stenosis.

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“…Alternatively, catheter-directed thrombosis is related to hemorrhage. Moreover, the procedure is time-consuming and requires intensive care and repeated angiograms [17]. The AngioJet system is a rheolytic thrombectomy device that has been proven successful in eliminating thrombus from dialysis grafts, bypass grafts, and native arteries [8].…”

Section: Discussionmentioning

confidence: 99%

Combination of Rotarex Thrombectomy and Angioplasty in the Treatment of Aortic Endograft Occlusion

Li,

Qin,

et al. 2023

IJS

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Objective: The aim of this retrospective single-center study was to assess the effectiveness and safety of Rotarex thrombectomy and angioplasty (balloon dilatation and stenting) in the treatment of aortic endograft occlusion (AEO) after the endovascular repair of abdominal aortic aneurysm (AAA). Methods: Among a total of 683 patients who underwent the endovascular aneurysm repair (EVAR) for AAA between May 2010 and March 2020, 46 (6.7%) patients developed occlusions of the aortic endograft; 16 patients were treated with fogarty embolectomy, 4 were treated with AngioJet aspiration, and 26 patients with mechanical thrombectomy (Rotarex system). The average time for AEO was 5 weeks (range 2-11 weeks). Immediately after angiography, Rotarex thrombectomy was used to remove the thrombus and embolus. After thrombectomy, balloon dilation was performed, followed by stent-graft deployment. The patients’ characteristics, treatment details, and outcomes were collected and analyzed. Results: There were 26 patients with AEO, 20 males (76.9%), and with the mean age of 67 ± 12 years (51-87). The primary reasons for AEO were kinking or extrinsic compression of the graft limb and thrombosis. The circulation was successfully restored in all patients by mechanical thrombectomy. Additional dilation/stents were required for 24 patients (93.3%), and they were placed in the graft limbs, thus re-establishing patency. The complications were observed in five patients and included peripheral embolization blue toe syndrome found in three patients and ischemia-reperfusion injury found in two patients. No mortality or recurrent thrombosis was observed in the follow-up period, which was extended for 12 months. Conclusions: The combination of Rotarex thrombectomy and angioplasty is a safe and effective treatment method for AEO after endovascular AAA repair.

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Comparison of Low-Dose Catheter-Directed Thrombolysis with and without Pharmacomechanical Thrombectomy for Acute Lower Extremity Ischemia

Cited by 19 publications

References 10 publications

Retrograde pedal access and percutaneous mechanical thrombectomy for salvage of an occluded vein bypass

Retrograde pedal access and percutaneous mechanical thrombectomy for salvage of an occluded vein bypass

Observation of the effect of angiojet to treat acute lower extremity arterial embolization

Combination of Rotarex Thrombectomy and Angioplasty in the Treatment of Aortic Endograft Occlusion

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