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Published on: September 22, 2020
Twelve-Month Amputation-Free Survival after AngioJet Thrombectomy for Acute and Subacute Lower Extremity Arterial
Shuming Zhang1, Jianyun Long2, Fan Yang2
1Hangzhou Normal University Division of Health sciences, Hangzhou First People's Hospital, Hangzhou, Zhejiang, China.
Background:
This study aimed to evaluate the 12-month efficacy and safety of AngioJet rheolytic thrombectomy in patients with acute and subacute lower extremity arterial thrombosis.
Methods:
This was a prospective, multicenter, single-arm cohort study (NCT04861506) conducted at 7 tertiary centers in China. A total of 203 consecutive patients with acute/subacute limb ischemia (Rutherford I-IIb) underwent AngioJet pharmacomechanical thrombectomy between February 2021 and May 2023. The primary end points were 12-month amputation-free survival (AFS) and VascuQoL scores. The secondary end points included technical success, thrombus removal grade, perioperative complications, and freedom from major adverse events (MAEs).
Results:
Device safety was 100%, and technical success was 97.5% (198/203). Complete thrombus removal (grade 0) was achieved in 79.8% (162/203). At 12 months, AFS was 92.1% (95% confidence interval [CI]: 87.4-95.0%), and freedom from MAEs was 79.8% (95% CI: 74.9-86.0%). VascuQoL scores improved from 2.43 ± 1.28 to 4.76 ± 1.21 (P < 0.001). Perioperative complications occurred in 22.2% of patients, with major complications occurring in 6.9%. Complete thrombus removal, tibial runoff score ≤5, and postoperative anticoagulation were independent predictors of limb salvage (all P < 0.05).
Conclusion:
AngioJet thrombectomy provides high technical success and durable 12-month limb salvage with acceptable safety in acute and subacute lower extremity arterial thrombosis. Complete thrombus removal, favorable runoff, and postoperative anticoagulation are key prognostic factors.
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