Yiğit Görkem, Türkmen Ufuk
Department of Cardiovascular Surgery, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey.
Department of Cardiovascular Surgery, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey.
J Vasc Surg Venous Lymphat Disord. 2025 May;13(3):102192. doi: 10.1016/j.jvsv.2025.102192. Epub 2025 Jan 19.
This 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.
From 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.
The 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.
AngioJet 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.
本研究旨在探讨AngioJet机械性血栓切除术（RT）治疗急性双侧髂股深静脉血栓形成（IFDVT）患者的早期临床结局，特别关注血栓形成后综合征的发生率。
对2021年3月至2023年8月在本中心接受AngioJet RT治疗的16例连续急性双侧IFDVT患者进行评估。主要结局包括目标静脉通畅情况、血栓形成后综合征的发生、复发性深静脉血栓形成（DVT）以及与手术相关的死亡。次要结局包括轻微或严重出血、急性肾损伤、记录到的血红蛋白尿、心脏事件、肺栓塞、肢体缺失和死亡。
患者的平均年龄为69±12岁（范围53 - 87岁）。恶性肿瘤和近期大手术是最常见的危险因素，各在25%的患者（n = 4）中观察到。所有患者（n = 16；100%）均实现了技术成功、完全清除血栓并缓解症状。四分之一的患者（n = 4）在手术后出现短暂性血红蛋白尿。经充分补液后，该并发症自发缓解。3例患者（19%）发生轻微出血，而无患者出现严重出血并发症。有1例术后急性肾损伤和短暂性心动过缓（6%）。3例患者在手术后死亡（19%）。1例患者（6%）发生术后大面积肺栓塞。平均随访时间为11±6个月（范围5 - 19个月）。术后6个月和12个月时，主要通畅率分别为92%和91%。1例患者在随访期间出现再闭塞。
应用于双侧IFDVT患者的AngioJet RT前景良好，可提供通畅的静脉腔，手术成功率高，并能使生活质量受损的严重症状患者在早期获得令人信服的症状改善。在这个早期病例系列中，AngioJet设备在老年病例中的可行性似乎是一个重大问题。因此，患者选择至关重要。
