Rheolytic thrombectomy in the management of acute lower extremity arterial ischemia

Objective: To investigate the percutaneous AngioJet thrombectomy in the treatment of acute limb ischemia (ALI). Methods: The clinical data of 5 patients with acute lower extremity ischemia (ALI) confirmed by DSA angiography, who later were treated by AngioJet thrombectomy in our hospital during January to December 2016, were retrospectively analyzed. Percutaneous mechanical thrombectomy (PMT) by AngioJet was performed on all five patients followed by adjunctive pharmacotherapy. The patency rate of lower extremity artery was assessed by color Doppler Ultrasound at 1 and 12 months after discharge. Results: Nine arterial occlusion sites in all 5 patients were treated with PMT. Angiography after the thrombectomy procedure showed 7 limbs fulfilled grade Ⅲ while two sites reached gradeⅡ criteria. All patients were followed up for 2 to 13 months, with an average of (9.0±4.3) months. During the follow-up, one patient had recurrent intermittent claudication. There was no recurrence of the lower extremity arterial thrombosis, no death and limb amputation during the follow-up periods. Conclusions: Percutaneous AngioJet thrombectomy provides a rapid reperfusion to the ischemic extremity, and the short-term follow-up is satisfactory in the treatment of arterial fresh thrombosis. Key words: Acute limb ischemia; Lower extremity; Embolism and thrombosis; Intervention treatment; Mechanical thrombectomy