Application of AngioJet rheolytic thrombectomy in the treatment of acute limb ischemia / 介入放射学杂志

ABSTRACT

Objective To investigate the effectiveness and safety of AngioJet rheolytic thrombectomy in the treatment of acute limb ischemia (ALI). Methods The clinical data of a total of 19 patients with ALI of lower limbs, who were treated with AngioJet rheolytic thrombectomy, were retrospectively analyzed. The patients included 14 males and 5 females, with a mean age of (77.7±6.8)years old (66-90 years old). The thrombus clearance rate ≥90％ was defined as grade Ⅲ, 50％-90％ as grade Ⅱ, and <50％ as grade I, which was used to evaluate the thrombus clearance effect. The postoperative device-related complication, amputation incidence and the mortality were recorded. Results In all the 19 patients, the technical success rate was 100％. The thrombus clearance rate after initial AngioJet rheolytic thrombectomy was >50％ in all patients, among them grade Ⅲ was obtained in 14 patients (73.7％) and grade Ⅱ in 5 patients (26.3％). The symptoms of lower extremity pain, ischemia, etc. were improved. In 5 patients, macroscopic hemoglobinuria occurred once after the treatment. No serious complications such as bleeding at puncture point, hemorrhage of digestive tract, renal function damage or death occurred. Limb salvage was achieved in17, with a limb salvage rate of 89.5％, the 6-month and one-year limb salvage rates were 84.6％ (11/13) and 80.0％ (8/10) respectively. Conclusion For the treatment of ALI of lower limbs, AngioJet rheolytic thrombectomy is safe and effective, it can rapidly recover arterial blood flow. AngioJet rheolytic thrombectomy is especially suitable for the elderly patients and the patients who have high risk for surgical operation or have contraindications for thrombolysis.