Pharmacomechanical thrombectomy: 2015 update

Abstract

Pharmacomechanical Thrombectomy (PMT) is recognized as a recent advancement in the treatment of lower extremity deep venous thrombosis (DVT). Evidence for the use of this modality is growing rapidly, primarily based on anecdotal experience and large case series. Currently, the majority of patients with lower extremity DVT are treated with anticoagulation or compressive therapy without adjunctive surgical or interventional procedures. This article reviews the current evidence supporting the use of PMT over catheter directed thrombolysis or simple anticoagulation and the expected benefits that can be realized from each modality. In addition the relevant unique characteristics to each device currently available are described focusing on mechanism of action and potential side effects.

Evaluation of ultrasonic intravascular thrombectomy system on a rabbit model in the treatment of deep vein thrombosis

“…In addition, they reduce hospital costs by preventing long hospitalizations [16]. However, the use of significant amounts of fibrinolytic agents in pharmacomechanical methods increases the risk of bleeding [17].…”

Midterm Outcomes of Pharmacomechanical Thrombectomy in the Treatment of Lower Extremity Deep Vein Thrombosis With a Rotational Thrombectomy Device

“…The Cleaner requires less overhead cost and even works with standard angiographic injectors. 24 Information about the outcomes of the Cleaner system is based on data from several recently published observational studies. [25][26][27][28][29] However, there are currently no randomized, controlled trial studying outcomes for this device in the literature.…”

Our anesthesia experience in reolytic pharmaco-mechanical thrombectomy performed by AngioJet in pulmonary embolism cases

“…Diğer bir grup mekanik trombektomi cihazları ise direk damar duvarına temas etmezler ve pıhtıyı parçalamak için basınçlı salin veya trombolitik ajan kullanılır. Bu yüksek basınçlı akımın proksimalinde Venturi etkisi olarak adlandırılan vakum fenomeni oluşur ve parçalanan trotik materyal kateter aracılığı ile tahliye edilir (9). Bu işlem reolitik trombolizis olarak tanımlanır ve AngioJet (Boston Scientific, Marlborough, USA) en sık kullanılan ve çalışılan kateterdir (8,9).…”

“…Bu yüksek basınçlı akımın proksimalinde Venturi etkisi olarak adlandırılan vakum fenomeni oluşur ve parçalanan trotik materyal kateter aracılığı ile tahliye edilir (9). Bu işlem reolitik trombolizis olarak tanımlanır ve AngioJet (Boston Scientific, Marlborough, USA) en sık kullanılan ve çalışılan kateterdir (8,9). Perkütan temelli girişimlerin uygulandığı hastalar, sıklıkla hemodinamik açıdan instabil ve solunum sıkıntısı olan kişilerdir.…”