Percutaneous mechanical thrombectomy in acute and subacute lower-extremity ischemia: impact of adjunctive, solely nonthrombolytic endovascular procedures

Fluck, Friederika; Stephan, Maximilian; Augustin, Anne Marie; Rickert, Nicole; Bley, Thorsten Alexander; Kickuth, Ralph

doi:10.5152/dir.2021.19403

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Data regarding the outcomes of thrombectomy procedures in peripheral limb ischaemia are more profound. The initial clinical success ranges from 88 to 92.2% for mechanical thrombectomy [4,[16][17][18] to 83-100% for rheolytic thrombectomy [7,19]. De Donato et al reported a primary patency rate of 77.5%/70.4% after 12/24 months for traditional surgical FM, and improved results of 94.0%/87.1% if additional angiography was performed [20].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series

Sieren

Pfarr

Aludin

et al. 2022

Cardiovasc Intervent Radiol

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Objective Thrombectomy of the aortoiliac segment remains a challenge for surgical and endovascular revision. This study aimed to evaluate the concept of percutaneous thrombectomy in patients with aortoiliac segment occlusions. Materials & Methods Eighteen patients with aortoiliac occlusion who underwent percutaneous thrombectomy were retrospectively identified using the local picture archive and divided into the stent-graft (N = 10) and native vessels (N = 8) groups. The procedure was performed by placing a 12–24 French sheath adjacent to the distal end of the occluded vessel segment. The occlusion was passed with a balloon catheter which was retracted after inflation, to deliver the thrombus into the sheath. Technical success (reperfusion of the vessel and no residual thrombus/stenosis < 30%), complications and primary arterial patency were assessed. Follow-up included computed tomography angiography and evaluation of the clinical situation via telephone. Results Technical success was achieved in 38% (7/18) of patients after percutaneous thrombectomy alone and in 100% after additional procedures. The most common complication was peripheral embolism (44%, 8/18), which was treated successfully in all cases and was linked to a mismatch between the sheath and target vessel of ≥ 1 mm (P < .01). There were no significant differences in the incidence of complications between the two groups. Primary patency was 72% (13/18) with no significant difference between groups (P = .94). Follow-up CT scans were available for 13/18 patients (72%), with a mean follow-up time of 270 ± 146 days. All patients were contacted via phone (follow-up time, 653 ± 264 days). Conclusion Percutaneous thrombectomy appears to be effective for revascularization of the aortoiliac segment, both in stent-grafts and in native vessels. The most common complication is peripheral embolism; however, the risk may be reduced by choosing an adequate sheath size.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series

Sieren

Pfarr

Aludin

et al. 2022

Cardiovasc Intervent Radiol

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“…While many studies focused on early success after PT, most of them do not include medium-and long-term results for various reasons. Complications are the most undesirable events of invasive procedures [12]. Dumantepe and Uyar stated that slight leg pain and hemoglobinuria were the most common complications after PT with 16.1% and 11.7% rates, respectively [5].…”

Section: Discussionmentioning

confidence: 99%

“…Complications are the most undesirable events of invasive procedures [ 12 ]. Dumantepe and Uyar stated that slight leg pain and hemoglobinuria were the most common complications after PT with 16.1% and 11.7% rates, respectively [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Thrombectomy for the Treatment of Lower Extremity Deep Vein Thrombosis: Medium-Term Follow-up Results and Analysis of 112 Cases

Cetin¹,

Sevgili²

2022

Cureus

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The aim of this study was to analyze percutaneous thrombectomy (PT) outcomes for the management of lower extremity deep vein thrombosis (DVT) with medium-term follow-up. MethodsThe study included charts of patients who underwent PT due to lower extremity DVT between August 2017 and March 2021. Patient characteristics and procedure outcomes were recorded in the electronic information system on the same day as the procedure. The procedures with complete removal of thrombus following PT without requiring additional procedure or additional thrombectomy apparatus were considered successful. Also, duration of follow-up was noted. ResultsIn total, 112 patients were enrolled in the study. The femoropopliteal (40.2%) and iliofemoral (25.0%) veins were the most common sites with thrombus detected. The duration of PT procedure and fluoroscopy were 123.1 minutes and 21.9 minutes, respectively. Estimated blood loss was 255.1 milliliters. The hospital stay and intensive care unit stay following PT were 3.7 and 1.4 days, respectively. Major hemorrhage did not occur in any patient, but we encountered bradycardia in six (5.4%) patients, acute renal failure in one (0.9%) patient, hemoglobinuria in 11 (9.8%) patients, leg pain in 15 (13.4%) patients, and pulmonary embolism in 2 (1.8) patients, respectively. Success of the present study was 94.6% in the first month, and re-operation was required only in one patient. The mean follow-up period was 21.1 months with 90.2% venous patency rates. ConclusionThe present study demonstrated that PT was an effective and reliable treatment modality with acceptable complication rates for the treatment of lower extremity DVT. Additionally, the efficacy of PT was proven by mid-term follow-up results.

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Safety and efficacy of mechanical aspiration thrombectomy for patients with acute lower extremity ischemia

Maldonado,

Powell,

Wendorff

et al. 2024

Journal of Vascular Surgery

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Percutaneous mechanical thrombectomy in acute and subacute lower-extremity ischemia: impact of adjunctive, solely nonthrombolytic endovascular procedures

Cited by 4 publications

References 24 publications

Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series

Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series

Percutaneous Thrombectomy for the Treatment of Lower Extremity Deep Vein Thrombosis: Medium-Term Follow-up Results and Analysis of 112 Cases

Safety and efficacy of mechanical aspiration thrombectomy for patients with acute lower extremity ischemia

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