6533b850fe1ef96bd12a82cf

RESEARCH PRODUCT

Therapie thrombembolischer Verschlüsse der Unterschenkelarterien: Klinische Erfahrungen mit dem Angiojet®-Thrombektomiekatheter

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UNLABELLED To investigate the clinical impact of a new hydrodynamic thrombectomy catheter in thromboembolic occlusion of tibial arteries. METHOD 10 patients with thromboembolic occlusion of all tibial arteries were treated with the Angiojet thrombectomy device in order to reestablish blood flow. Depending on angiographic and clinical results of thrombectomy, additional thrombolysis, PTA, recanalization, or surgical bypass grafting was performed. RESULTS Antegrade blood flow in at least one tibial artery was reestablished in 6 cases with the thrombectomy device. However, additional treatment modalities were used in order to improve the outcome and to resolve adherent thrombi or to treat vessel stenoses and occlusions: thrombolysis (n = 9), PTA (n = 3), recanalization (n = 1), bypass grafting (n = 3), suction thromboembolectomy (n = 1), replacement of popliteal aneurysm (n = 1). The limb salvage rate was 7/10. The ratio of injected volume to aspiration volume was 1.04 +/- 0.07 indicating that the system works isovolumetrically. The device induced moderate hemolysis with plasma free hemoglobin rising by the factor 12.91 +/- 11.59, (P < 0.01). CONCLUSION In cases with thromboembolic occlusions of tibial arteries the Angiojet thrombectomy catheter is a valuable addition to the interventional instrumentarium. It works isovolumetrically but induces moderate hemolysis and thereby may compromise renal function. However, in most cases additional treatment modalities are required.