Dataset Information

Clinical outcomes of AngioJet rheolytic thrombectomy in the treatment of May-Thurner syndrome-related deep venous thrombosis.

ABSTRACT:

Objective

May-Thurner syndrome (MTS) is an anatomic stenotic variation associated with deep vein thrombosis (DVT) of the left leg. The classical DVT treatment strategy is medical treatment without thrombus removal. This study was performed to assess the clinical outcomes of the combination of AngioJet™ rheolytic thrombectomy and stenting for treatment of MTS-related DVT.

Methods

We conducted a retrospective cohort study of patients treated for MTS-related DVT from January 2017 to June 2020 at a single institution.

Results

Fourteen patients (nine women) underwent AngioJet™ rheolytic thrombectomy for MTS-related DVT during the study period. The median DVT onset time was 8 days (interquartile range (IQR), 3-21 days). The median procedure time was 130 minutes (IQR, 91-189 minutes), and the median hospital stay was 7 days (IQR, 5-26 days). One patient had a residual thrombus and occluded iliac stent and underwent adjuvant catheter-directed thrombolysis for revascularization. The primary patency rate for the iliac stent was 92.9% at 12 months.

Conclusion

Concomitant AngioJet™ rheolytic thrombectomy and stenting of MTS-induced lesions may be beneficial for patients with MTS-related DVT.

SUBMITTER: Wei WC

PROVIDER: S-EPMC9168862 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Clinical outcomes of AngioJet rheolytic thrombectomy in the treatment of May-Thurner syndrome-related deep venous thrombosis.

Wei Wen-Cheng WC Hsin Chun-Hsien CH Yang Hsuan-Tzu HT Su Ta-Wei TW Su I-Hao IH Chu Sung-Yu SY Ko Po-Jen PJ Yu Sheng-Yueh SY Lee Chun-Hui CH

The Journal of international medical research 20220601 6

<h4>Objective</h4>May-Thurner syndrome (MTS) is an anatomic stenotic variation associated with deep vein thrombosis (DVT) of the left leg. The classical DVT treatment strategy is medical treatment without thrombus removal. This study was performed to assess the clinical outcomes of the combination of AngioJet™ rheolytic thrombectomy and stenting for treatment of MTS-related DVT.<h4>Methods</h4>We conducted a retrospective cohort study of patients treated for MTS-related DVT from January 2017 to ...[more]

PMID: 35650686

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Project description:PurposeThe present study aimed to investigate the preliminary safety and efficacy of rheolytic thrombectomy (RT) using an AngioJet Zelante DVT catheter or a Solent Omni catheter for acute proximal deep vein thrombosis (DVT).Material and methodsWe conducted a retrospective review of 40 patients who were treated with an AngioJet RT between January 2019 and January 2021, and then the patients were divided into the ZelanteDVT group (n = 17) and the Solent group (n = 23). Data on demographics, clinical characteristics, technical success, clinical success, complications, and early follow-up were analysed.ResultsNo significant differences regarding demographics were detected (all p > .05). The technical success rates were both 100%. The ZelanteDVT group had a shorter duration of RT and a higher primary RT success than the Solent group (all p < .05), and the percentage of adjunctive catheter-directed thrombolysis (CDT) was 29.4% in the ZelanteDVT group, which was significantly lower than the 73.9% in the Solent group (p = .010). The clinical success rates for the ZelanteDVT group and Solent group were 100% (17/17) and 95.7% (22/23), respectively, and these values were high in the two groups (p > .05). Apart from transient macroscopic haemoglobinuria occurring in all the patients during the first 24 hours post-RT, none of the patients in either group suffered other procedure-related adverse events or major complications. Minor complications included bleeding events in 21.7% (5/23) of the patients in the Solent group and one (5.9%) patient in the ZelanteDVT group (p > .05). At 6 months, the frequency of PTS was 5.9% (1/17) in the ZelanteDVT group and 17.4% (4/23) in the Solent group (p > .05).ConclusionBoth catheters are safe and effective in managing patients with proximal DVT, thus leading to improved clinical outcomes with few complications. The ZelanteDVT catheter was more effective than the Solent catheter in thrombectomy, thus allowing for faster extraction of the DVT with a shorter run time and lower proportions of patients with adjunctive CDT.

Project description:ObjectiveThis study aimed to examine the early clinical outcomes of AngioJet rheolytic thrombectomy (RT) in patients with acute bilateral iliofemoral deep vein thrombosis (IFDVT), with a specific focus on the incidence of post-thrombotic syndrome.MethodsFrom March 2021 to August 2023, 16 consecutive patients with acute bilateral IFDVT treated with AngioJet RT at our center were evaluated. Primary outcomes include patency of the target veins, development of post-thrombotic syndrome, recurrent DVT, and procedure-related death. Secondary outcomes included minor or major bleeding, acute kidney injury, documented hemoglobinuria, cardiac event, pulmonary embolism, limb loss, and death.ResultsThe mean age of the patients was 69 ± 12 years (range, 53-87 years). Malignancy and recent major surgery were the most prevalent risk factors, each observed in 25% of patients (n = 4). Technical success, complete clot removal, and alleviation of symptoms were achieved in all patients (n = 16; 100%). In one-quarter of the patients (n = 4), transient hemoglobinuria was observed following the procedure. This complication resolved spontaneously after adequate fluid replenishment. Minor bleeding occurred in three patients (19%), whereas no patients had major bleeding complication. There was one postoperative acute kidney injury and transient bradycardia (6%). Three patients died after the procedures (19%). One patient (6%) developed postoperative massive pulmonary embolism. The mean follow-up was 11 ± 6 months (range, 5-19 months). The primary patency rate was 92% and 91%, respectively, 6 and 12 months after procedures. One patient had reocclusion during the follow-up.ConclusionsAngioJet RT applied to patients with bilateral IFDVT provides a promising picture, providing a patent vein lumen with high procedural success and achieving convincing early symptomatic improvement in severely symptomatic patients with impaired quality of life. In this early case series, the feasibility of the AngioJet device in elderly cases appears to be a significant problem. Therefore, patient selection is essential.

Project description:BackgroundCerebral venous thrombosis (CVT) is a rare condition that presents with significant treatment challenges and has traditionally been managed with anticoagulation. However, for patients who fail anticoagulation or present with severe symptoms, endovascular thrombectomy (EVT) has emerged as a favorable treatment modality. This study examines the outcomes, complications, and comorbidities associated with EVT in patients with CVT.MethodsA query of the 2015-2019 National (Nationwide) Inpatient Sample was performed for patients admitted to hospitals with ICD-10 diagnosis codes for CVT and ICD-10 procedure codes for usage of EVT. Demographic information, baseline comorbidities, complications, and discharge dispositions were compared between patients who underwent EVT and those who were managed medically.ResultsA total of 36,005 patients diagnosed with CVT were identified from 2015(Q4) to 2019. Of these patients, 325 (0.9%) received EVT. Patients who underwent EVT were older (<0.001), more likely to be female (p = 0.016), and had higher rates of diabetes mellitus (p = 0.012), hypertension (p < 0.001), and obesity (p < 0.001). These patients also presented with more severe neurological symptoms, including higher National Institutes of Health Stroke Scale scores (p < 0.001), coma (p < 0.001), and cerebral edema (p < 0.001). Patients undergoing EVT had a higher incidence of in-hospital mortality (p = 0.007) and were less likely to be discharged routinely (p < 0.001).ConclusionsThis study found that patients with CVT who underwent EVT were older, more likely to be female, and presented with more severe neurological conditions. After controlling for severity, EVT in patients with CVT was associated with significant risks, including higher rates of complications and inpatient mortality. Although EVT is associated with significant risks, the findings of this study suggest that its outcomes may reflect the severity of the underlying condition rather than the procedure itself. Careful patient selection and individualized management strategies are essential for optimizing outcomes in this high-risk population.

Dataset Information

Clinical outcomes of AngioJet rheolytic thrombectomy in the treatment of May-Thurner syndrome-related deep venous thrombosis.

Objective

Methods

Results

Conclusion

Publications

Clinical outcomes of AngioJet rheolytic thrombectomy in the treatment of May-Thurner syndrome-related deep venous thrombosis.

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