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Percutaneous thrombectomy: a review
Robert Morgan1, Anna-Maria Belli
1Department of Vascular Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT, UK. robert.morgan@stgeorges.nhs.uk
Insights
Percutaneous thrombectomy (PT) effectively removes blood clots from arteries and veins. This technique includes aspiration and mechanical methods, offering versatile solutions for vascular occlusions.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Percutaneous thrombectomy (PT) is a recognized procedure for removing acute thrombus from occluded arteries, veins, and vascular grafts.
- PT can be employed as a standalone therapy or as an adjunct to other thrombus removal methods like thrombolysis.
Purpose of the Study:
- To outline the established techniques and applications of percutaneous thrombectomy in vascular interventions.
- To differentiate between aspiration and mechanical thrombectomy methods and their respective clinical uses.
Main Methods:
- Percutaneous aspiration thrombectomy utilizes suction via wide-bore catheters for thrombus removal.
- Mechanical thrombectomy employs automated devices to fragment or extract thrombus.
Main Results:
- Aspiration thrombectomy serves as an adjunct to thrombolysis in acute arterial occlusion and as salvage therapy for distal emboli post-angioplasty.
- Mechanical thrombectomy is effective for thrombosed dialysis grafts and is increasingly used for pulmonary emboli and deep venous thromboses.
Conclusions:
- Percutaneous thrombectomy offers diverse approaches for managing acute vascular thrombus.
- Both aspiration and mechanical methods demonstrate utility across a spectrum of vascular conditions, from arterial occlusions to deep vein thromboses.
Abstract:
Percutaneous thrombectomy (PT) is an established technique for the removal of acute thrombus in occluded arteries, veins and vascular grafts. Percutaneous thrombectomy can be used as an adjunctive treatment to other methods of thrombus removal such as thrombolysis or as sole therapy. The two main methods are percutaneous aspiration thrombectomy in which thrombus is removed by suction with the aid of wide-bore catheters, and mechanical thrombectomy using a variety of automated devices to fragment or remove thrombus. Aspiration thrombectomy is often used as an adjunct to thrombolysis in acute arterial occlusion, or as salvage therapy to remove distal emboli following iliac or femoropopliteal angioplasty. Mechanical thrombectomy is useful for the treatment of thrombosed dialysis grafts and is being increasingly used for the treatment of massive pulmonary emboli and ileofemoral or ileocaval deep venous thromboses.