Application of AngioJet in treatment of lower extremity arterial thromboembolic disease
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R654.3

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    Abstract:

    Objective: To investigate the clinical efficacy of using AngioJet in treatment of lower extremity arterial thromboembolic disease and report the preliminary experience. Methods: The clinical data of 10 patients with lower extremity arterial thromboembolic disease (3 cases of acute arterial embolism of the lower extremities, 5 cases of acute thrombosis secondary to arteriosclerosis obliterans of the lower limbs, and 2 cases of primary thrombosis) undergoing thrombus aspiration with AngioJet system from August 2016 to July 2017 in Zhongshan Hospital of Fudan University were retrospectively analyzed. Results: The operations in all the 10 patients (mean age of 61.60 years) were successfully completed by using AngioJet alone or together with other modalities, and the technique successful rate was 100%. Of the patients, stenosis disappeared in 2 cases after AnigoJet aspiration alone, 6 cases underwent balloon angioplasty and 2 cases underwent balloon angioplasty plus stenting due to residual stenosis after AnigoJet aspiration. Due to presence of remnant thrombi, 3 cases undergoing AnigoJet aspiration plus balloon angioplasty and one case undergoing AnigoJet aspiration plus balloon angioplasty and stenting were assisted by pulse-spray thrombolysis, and one case undergoing AnigoJet aspiration plus balloon angioplasty and one case undergoing AnigoJet aspiration plus balloon angioplasty and stenting were assisted by catheter directed thrombolysis (CDT). The average length of postoperative hospital stay was (3.9±2.3) d. The postoperative ankle-brachial index was significantly increased compared with the preoperative value (0.84 vs. 0.37, P<0.05). Hematuria and mild renal impairment occurred in one case each after operation. The treatment effectiveness assessment showed that 6 patients had complete cure and 4 patients had good response. Six-month follow-up was completed in 7 patients, and no exacerbation of limb ischemia was noted. Conclusion: Thrombus aspiration using AngioJet system is safe, effective and less invasive for acute lower extremity arterial thromboembolic disease, and is especially suitable for thromboembolic lesions in the femoropopliteal segment. The residual stenosis after aspiration can be corrected by balloon angioplasty or combined with stent implantation, and CDT can be applied for those with ineffective thrombus aspiration.

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HAN Song, ZHOU Xiushi, LIU Fei, SHI Zhenyu, TANG Xiao, YAN Dong, GUO Daqia. Application of AngioJet in treatment of lower extremity arterial thromboembolic disease[J]. Chin J Gen Surg,2017,26(12):1575-1582.
DOI:10.3978/j. issn.1005-6947.2017.12.011

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History
  • Received:August 29,2017
  • Revised:November 07,2017
  • Adopted:
  • Online: December 15,2017
  • Published: