ObjectiveTo evaluate the effect of percutaneous mechanical thrombectomy (PMT) with AngioJet mechanical thrombus aspiration system for the acute deep venous thrombosis (DVT) of lower extremities. MethodsThe clinical data of 72 patients (72 limbs) with acute DVT who underwent PMT with AngioJet system from December 2015 to June 2018 in our hospital were analyzed retrospectively. ResultsOf the 72 cases, 30 cases underwent PMT alone, while 42 cases underwent PMT combined with catheter directed thrombolysis (CDT). Thrombus clearance rate of grade Ⅲ was obtained in 49 cases (68.05%), grade Ⅱ in 20 cases (27.78%), and grade Ⅰ in 3 cases (4.17%). Thirty-five cases were found with May-Thurner syndrome, and 34 cases were treated with stenting while 1 case complicated with iliac bleeding. The rates of PTS were 1.41% (1/71), 3.57% (2/56), 4.55% (2/44), and 20.00% (3/15) at 3-month, 6-month, 1-year, and 2-year after intervention, respectively. The deep vein patency rates were 86.36% (38/44) and 80.00% (12/15) at 1-year and 2-year after intervention, respectively. The iliac stent patency rates were 100% (23/23) and 87.50% (7/8) at 1-year and 2-year after intervention, respectively. ConclusionThe effect of PMT assisted with CDT for the acute DVT of lower extremities is satisfactory, but its long-term efficacy needs to be further observed.
ObjectiveThis study was aimed to evaluate the clinical efficacy of mechanical thrombectomy using the AngioJet System for the treatment of lower extremity acute arterial embolism and thrombosis.MethodsThe clinical data of 20 patients with acute lower extremity arterial embolism and thrombosis admitted to the Department of Vascular Surgery in the People’s Hospital in Gansu Province where the author worked from September 2016 to March 2017, were retrospectively analyzed. All patients were treated with the AngioJet mechanical thrombectomy system. Clinical data of the patients were retrospectively collected. The clinical efficacy of AngioJet mechanical thrombectomy wasanalyzed.ResultsEighteen (90.0%) of the 20 patients successfully completed the mechanical thrombectomy by using the AngioJet System. The mean time for hospital stay and operation was (4.2±1.4) d and (1.3±0.4) h, respectively. The average doses of urokinase and heparin during operation were (35.80±12.30) ×104 U and (45.10±8.30) mg, respectively. Two patients received a complementary treatment of incision for removing the thrombus. Two patients received catheter-directed thrombolysis after the mechanical thrombectomy, 5 patients received bare-metal stent implantation after balloon expansion. Clinical success was in 16 cases. According to the Cooley standard, 10 patients were in excellent condition,6 in good condition, 2 in fair condition, and 2 in poor condition. There were 2 cases of distal arterial embolization,2 cases of antecardial discomfort of bradycardia, and 4 cases of bleeding at the puncture point, but no serious bleeding complications such as gastrointestinal and intracranial hemorrhage occurred. A total of 16 patients presented myoglobinuria during and after operation. All patients were followed up for 6–12 months. The results of ultrasound examination showed that the artery was patency in 15 cases. One patient died of myocardial infarction in 9 months after surgery,2 patients developed lower extremity ischemia symptoms again after surgery, and 2 patients had lower extremity ulcer caused by lower extremity ischemia symptoms. During the follow-up period, no lower limb necrosis, amputation, and death occurred in the remaining patients.ConclusionsThe AngioJet mechanical thrombectomy system is safe and effective. Combined with the use of catheter-directed thrombolysis and stent implantation, the AngioJet mechanical thrombectomy could lead to quick recovery of the perfusion of the lower extremity and improve the limb salvage rates, exhibiting excellent clinical value.
ObjectiveTo systematically evaluated the efficacy of AngioJet mechanical thrombectomy and catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity deep venous thrombosis (LEDVT).MethodsAccording to the retrieval strategy of Cochrane collaboration network, the relevant literatures in CNKI, WangFang, VIP, CBM, PubMed, Embase, Cochrane Library, Web of Science at home and abroad up to March 25, 2020 were collected, and the meta analysis was performed by using Review Manager 5.3 software.ResultsA total of 20 observational studies were included in the meta analysis. The total number of patients was 1 566, which 799 cases in the AngioJet group and 767 cases in the CDT group. The results showed that the AngioJet group had a higher patency rate of deep vein ［MD=11.34, 95%CI (6.16, 16.51), P<0.000 1］, lower or shorter Villalta score ［MD=–1.90, 95%CI (–2.71, –1.10), P<0.000 01］, incidence of post-thrombotic syndrome［PTS, OR=0.42, 95%CI (0.23, 0.77), P=0.005］, rate of clot reduction grade Ⅰ events ［OR=0.40, 95%CI (0.24, 0.67), P=0.000 5］, incidence of bleeding complication ［OR=0.32, 95%CI (0.21, 0.49), P<0.000 01］, and hospital stay ［MD=–2.96, 95%CI (–3.69, –2.22), P<0.000 01］.ConclusionsIn the early efficacy, AngioJet mechanical thrombectomy has better patency rate of deep vein and thrombolysis, shorter hospital stay, and lower risk of bleeding than CDT. In the mid-term effect, AngioJet mechanical thrombectomy could reduce the incidence and the severity of PTS.
Stroke is a disease that seriously affects the quality of life of patients. Its main characteristics are that the incidence rate is increasing year by year, the risk of death is high, and the prognosis of the disease is poor. For patients with acute cerebral artery occlusive ischemic stroke, intravenous thrombolysis alone has a low recanalization rate and poor long-term prognosis. With the development of interventional treatment technology for cerebrovascular disease, intravascular interventional treatment methods such as arterial thrombolysis, stent placement, and mechanical thrombectomy are more and more applied in the ultra-early stage of acute ischemic stroke. This article reviews the progress of mechanical thrombectomy in the treatment of cerebral artery occlusion in patients with acute ischemic stroke.
Objective To explore the impact of gender difference in 90-day outcomes after mechanical thrombectomy for acute cerebral infarction. Methods A prospective registration, observational, and retrospective analysis study was carried out. Patients with acute cerebral infarction who were admitted to the Department of Neurology of the First Affiliated Hospital of Chengdu Medical College and the Department of Neurology of Nanjing First Hospital between June 2015 and June 2019 were collected. Patients were divided into two groups based on gender. The detailed demographic, laboratory examination, imaging examination and clinical data were collected. Then, the data were analyzed using univariate and multivariate logistic regression analyses. Results A total of 298 patients were included. Among them, there were 185 males and 113 females. The differences in age, smoking, atrial fibrillation, using antiplatelet drugs before stroke, TOAST classification, and involved cerebrovascular sites between the two groups were statistically significant (P<0.05), and there was no statistically significant difference in other baseline data between the two groups (P>0.05). The results of univariate logistic regression analysis showed that the rate of 90-day favourable outcome of female patients was lower than that of male patients [odds ratio (OR)=0.462, 95% confidence interval (CI) (0.275, 0.775), P=0.030]. The results of multivariate logistic regression analysis showed that, after adjusting for confounding factors, there was no independent correlation between gender and the 90-day favourable outcome of patients with acute cerebral infarction who underwent mechanical thrombectomy [OR=1.511, 95% CI (0.745, 3.066), P=0.253]. Conclusion The gender has no significant effect on the 90-day favourable outcome of acute cerebral infarction patients treated with mechanical thrombectomy.