Percutaneous embolectomy by transcatheter aspiration. Work in progress.

Abstract

Distal embolization occurred in 14 of 339 (4%) attempted percutaneous transluminal angioplasty (PTA) procedures, including five of 225 stenoses (2.2%) and nine of the 81 occlusions (11%) that were crossed successfully in 114 attempts (8%). Transcatheter embolectomy by aspiration through a nontapered large-bore catheter was technically successful in five of six attempts (83%), and was combined with successful PTA in three of five patients. In two patients in whom the clinical result of PTA was considered unsatisfactory, successful transcatheter embolectomy permitted an uncomplicated surgical by-pass procedure to be performed. If clinically significant embolization occurs during PTA, this procedure can be attempted prior to surgical embolectomy as an alternative to local fibrinolytic therapy.

Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

“…The endovascular approach includes several revascularization techniques, among which transcatheter aspiration is considered a relatively new and revolutionary method [1]. This technique was introduced into clinical practice in the 1980s for the extraction of thromboembolic material and the subsequent treatment of acute limb ischemia [2,3]. Currently, transcatheter aspiration from the popliteal artery and the distal limb vasculature is a effective alternative to surgical embolectomy using a Fogarty catheter [4,5].…”

Treatment of acute lower limb ischaemia

“…Manual aspiration thrombectomy (MAT) via large lumen catheters was the fi rst method of endovascular arterial thrombus extraction [52,53]. Typically, it is utilised as an adjunctive procedure in patients with thromboembolic complications after endovascular procedures.…”

The Use of the “Preclosure” Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

“…For the treatment and the prevention of its sequelae, emergent percutaneous or surgical revascularization is used. For acute leg ischemia, percutaneous techniques are sufficient to resolve the occlusion in most of the cases and in particular elderly patients benefit from nonsurgical alternatives [1][2][3].…”

“…Percutaneous aspiration thrombectomy (PAT) has been a proven and effective technique since it was first described by Sniderman in 1984 [1][2][3]. Adjunctive use of catheterdirected local thrombolysis or mechanical clot fragmentation with angioplasty balloons may be adopted to facilitate the aspiration therapy.…”

“…The main limitation of the aspiration technique often involves the size and burden of the clot. To facilitate the procedure, larger aspiration catheters and consequently larger introduction sheaths, which are inherently associated with more access site complications, are desirable [1][2][3]. To control bleeding complications, a quick and reliable closure of the large access site is mandatory.…”